Fozekosh A. A., Truba Ia. P., Dziuryi I. V., Perepeka I. A., Lazoryshynets V. V

SURGICAL TREATMENT OF ANOMALOUS LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY

---

Show/Download

About the author:

Fozekosh A. A., Truba Ia. P., Dziuryi I. V., Perepeka I. A., Lazoryshynets V. V

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

An anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly that can lead to ischaemia and myocardial infarction and is one of the causes of early infant mortality and sudden death in adults. From 2008 to 2024, 20 patients underwent surgical correction of anomalous coronary vessels from the pulmonary artery at the Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. Preoperative echocardiographic examination revealed a reduced left ventricular ejection fraction in 3 (15%) patients, initially reduced in 2 (10%) and preserved in 15 (75%) patients. Mild mitral insufficiency was observed in 5 (25%) patients, moderate - in 11 (55%), and severe - in 4 (20%) patients. In 15 (75%) patients, concomitant congenital heart disease was detected in combination with an anomalous left coronary artery from the pulmonary artery. Hospital mortality in the early postoperative period was 5% (1 patient). Postoperative echocardiographic examination showed recovery of LV EF in 4 patients out of 5 who had reduced or moderately reduced LV EF before surgery. In 6 (30%) patients, moderate mitral insufficiency persisted after surgery. In 4 (20%) patients, pulmonary artery stenosis developed in the long-term postoperative period. 1 (5%) patient underwent reoperation for pulmonary artery stenosis one year after ALCAPA correction. Patients with anomalous left coronary artery have a significantly increased risk of complications such as myocardial infarction, arrhythmias, and even death, so timely diagnosis and surgical correction of the defect can considerably reduce this risk and improve prognosis.

Tags:

Bibliography:

1. Karolezak MA, Wietska J, Bec L, Madry W. Anomalous origin of the left coronary artery (LCA) from pulmonary trunk (Bland-White-Garland syndrome) with systemic collateral supply. MedSciMonit. 2001;7:755-8.
2. Bodian M, Traore P, Leye M, Mingou J, Diallo W, Aw F, et al. Rare Etiology of Reversible Hypokinetic Dilatated Heart Disease in Infants: Bland-White-Garland Syndrome (ALCAPA). World Journal of Cardiovascular Diseases. 2023;13:73-91. DOI: 10.4236/wjcd.2023.132006.
3. Yau JM, Singh R, Halpern EJ, Fischman D. Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery in Adults: A Comprehensive Review of 151 Adult Cases and A New Diagnosis in a 53-Year-Old Woman. Clin Cardiol. 2011;34(4):204-10. DOI: https:// doi.org/10.1002/clc.20848.
4. Mishra A. Surgical management of anomalous origin of coronary artery from pulmonary artery. Indian J Thorac Cardiovasc Surg. 2021;37(1):131-143. DOI: https://doi.org/10.1007/s12055-021-01147-8.
5. Dahle G, Fiane AE, Lindberg HL. ALCAPA, a possible reason for mitral insufficiency and heart failure in young patients. Scandinavian Cardiovascular Journal. 2007;41(1):51-58. DOI: https://doi.org/10.1080/ 14017430601050348.
6. Pavlyuk VI, Myshakivskyi OA, Zharinov OY. Ekhokardiografichni metody otsinky sistolichnoi funktsii ta funktsionalnykh rezerviv livoho shlunochka v patsiientiv z tyazhkoyu mitralnoyu nedostatnistyu. Kardiokhirurhiia ta interveniitsiina kardiolohiia. 2013;3:54-62. [in Ukrainian].
7. Voloshyna O, Dukova O, Balashova I, Lysyi I. Onovleni Yevropeiski (2021) ta Amerykanski (2022) klasifikatsii khronichnoi sertsevoi nedostatnosti: shcho vazhlyvo dlya praktikuyuchoho likarya. Praktykuyuchyy likar. 2022;(2-3):23-28. Dostupno: https://plr.com.ua/index. php/journal/article/ view/709. [in Ukrainian].
8. Yu J, Ren Q, Chen T, Qiu H, Wen S, Zhuang J, et al. Outcome of surgical repair of anomalous left coronary artery from the pulmonary artery in a single-center experience. Hellenic J Cardiol. 2023;73:47-52. DOI: https://doi.org/10.1016/j.hjc.2023.02.003.
9. Jinmei Z, Yunfei L, Yue W, Yongjun Q. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) diagnosed in children and adolescents. J Cardiothorac Surg. 2020;15(1):90. DOI: https://doi.org/10.1186/s13019-020-01116-z.

Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 2, 173, 281-288 pages, index UDC 616.131:616.132.2]-053.2-089

DOI:

10.29254/2077-4214-2024-2-173-281-288