Excellent functional result in children after correction of anomalous origin of left coronary artery from the pulmonary artery - a population-based complete follow-up study
Tiina Ojala 1*,
Jukka Salminen 1,
Juha-Matti Happonen 1,
Jaana Pihkala 1,
Eero Jokinen 1,
Heikki Sairanen 1
1 Hospital for Children and Adolescents, Helsinki, Finland
* To whom correspondence should be addressed. E-mail: tiina.ojala{at}utu.fi.
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Abstract |
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Surgical strategy to construct a two-coronary system for a patient with anomalous origin of coronary artery from pulmonary artery (ALCAPA) has evolved with time. Limited long-term follow-up data are available on these children. We report population based follow-up in children operated on for ALCAPA. In total, 29 patients underwent aortic reimplantation of ALCAPA between 1979 and 2006. Twenty (69%) children were repaired with direct aortic implantation, five (17%) with a modified tubular extension technique, and four (14%) patients with an intrapulmonary baffling technique. Early postoperative mortality (<30 days) was 17%. No late mortality (>30 days) was detected. The median length of follow-up was 11 years (range 10 months-27 years). Global left ventricular function by echocardiography (M-mode) was within normal limits (>30%) in all patients one year after operation. Functionally, 80% of patients were classified in class NYHA I, 20% in NYHA II, and 0% in NYHA classes III/IV at the time of the last examination. Excellent results with good long-term outcome can be achieved in infants with ALCAPA using reimplantation techniques. Normalization of cardiac function is expected within the first year in all operative survivors with a patent coronary system. Keywords: ALCAPA; Child; Coronary; Follow-up; Population-based
