Diagnosis and surgery of left coronary artery abnormally originating from pulmonary artery (10 cases reports) / 中华胸心血管外科杂志

ABSTRACT

Objective To summarize clinical characteristics, diagnosis and surgery of abnormally origination of left coronary artery from the pulmonary artery. Methods Clinical data of 10 patients with left coronary artery abnormally originating from pulmonary artery were analyzed, including 5 men and 5 women, aged from 13 to 40 years. Definite diagnosis was made by ultrasonic cardiogram (UCG) and cardiac catheter examination. Three cases were simply abnormal origination, six cases combined with MI, and one case combined with both MI and ventricular aneurysm of left ventricular apex. Ligation of the abnormal coronary artery was done in four patients, three were given pulmonary artery inner tunnel plasty under extrocorporeal circulation. Open implantation of left coronary artery to ascending aorta were done in 3 patients, while plasty of mitral valve were performed in 5 and ventricular aneurysm resection in 1. Results One patient died postoperatively. The follow-up ranged from 1 month to 11 years. One patient received replacement of mitral valve 16 months after first surgery due to severe MI. All the followed-up patients presented no myocardial ischemia or infarction, no residual shunt or late death. Cardiac function was rehabilitated to grade 1. Conclusion Obvious blood dynamics and cardiovascular morphology changes existed in patients with left coronary artery abnormally originating from pulmonary artery. Early diagnosis and surgery should be done. Proper surgical approach is the key to success.