[Mitral valve dysfunction caused by papillary muscle necrosis in patients with anomalous origin of the left coronary artery from the pulmonary trunk]. / Disfunção da valva mitral por necrose de músculo papilar em origem anômala de artéria coronária esquerda do tronco pulmonar.

The clinical evolution of mitral valve disfunction caused by papillary muscle necrosis in patients with anomalous origin of the left coronary artery from the pulmonary trunk was analysed in three children (one 42-day-old male, one five-month-old female and one seven-year-old female). Two patients had been submitted to surgical repair of the anomalous origin of the coronary artery; one of them without mitral repair had a bad evolution in the postoperative period, was reoperated for mitral valve replacement and died two days after surgery. The other patient with plastic of mitral valve had a good outcome. The data indicated that the surgical repair of mitral valve should be provided in cases of mitral valve incompetence secondary to anomalous origin of the left coronary artery from the pulmonary trunk.

Common arterial trunk associated with absence of right atrioventricular connexion.

Common arterial trunk is a rare congenital anomaly, usually found in the setting of a concordant atrioventricular connexion. The association of a common arterial trunk with absence of the right atrioventricular connexion is very rare, having, as far as we know, been reported only twice in the literature. In the case reported here the pulmonary arteries originated separately from the posterior wall of the arterial trunk, and the trunk overrode the septum between the dominant left- and the right-sided rudimentary right ventricle. We discuss the electrocardiographic features which can help in the diagnosis of this malformation.