ABSTRACT
The presumed limited growth potential of saphenous vein grafts has led many authorities to discourage their use in young children. We documented excellent growth and patency of a saphenous vein graft 13 years after operation in a 7-year-old child with coronary artery obstruction caused by Kawasaki disease.
Subject(s)
Coronary Artery Bypass , Mucocutaneous Lymph Node Syndrome/surgery , Saphenous Vein/transplantation , Age Factors , Body Height , Body Weight , Child , Collateral Circulation , Coronary Disease/etiology , Coronary Disease/surgery , Coronary Vessels/pathology , Follow-Up Studies , Humans , Male , Mucocutaneous Lymph Node Syndrome/complications , Saphenous Vein/growth & development , Vascular PatencyABSTRACT
A case of anomalous origin of the left coronary artery from the pulmonary artery in a 5-year-old child is presented. Surgical correction by means of a direct subclavian-coronary anastomosis was performed at normothermic temperatures without cardiopulmonary bypass. Pre- and postoperative studies including angiography are presented. The rationale for this approach and its benefits are compared to previously utilized surgical techniques. We feel that this method is superior in that it creates a two-coronary system without utilizing prosthetic or vein bypass grafts. It thus can be used in infancy, allows for future growth and development, and is not subject to the inherent deficiencies of prosthetic or vein grafts. All 4 known cases of subclavian-coronary anastomosis previously reported are discussed.
Subject(s)
Coronary Vessel Anomalies/surgery , Coronary Vessels/surgery , Subclavian Artery/surgery , Aortography , Child, Preschool , Coronary Vessel Anomalies/diagnostic imaging , Humans , MethodsABSTRACT
Interposition of the azygous vein between the subclavian and pulmonary artery is helpful in extending the subclavian artery, when additional length is required for a satisfactory anastomosis.
