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izquierda en la arteria - Archivo PPCT

Origen anómalo de la coronaria izquierda en la arteria;
Outcomes after Surgical Correction of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

Creators:Lugones, Ignacio; Servicio de Cirugía Cardiovascular Pediátrica. Hospital de Niños “Dr. Ricardo Gutiérrez”. Buenos Aires, Argentina, Kreutzer, Christian, Roman, Maria, Schlichter, Andres
2011-12-20

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RESUMENIntroducciónEl origen anómalo de la arteria coronaria izquierda en la arteria pulmonar es una cardiopatía congénita rara que produce isquemia miocárdica con disfunción ventricular izquierda e insuficiencia mitral de grado variable. Las técnicas actuales han modificado la historia natural de esta enfermedad mediante el restablecimiento de un sistema de doble irrigación coronaria.ObjetivosEvaluar la experiencia institucional en la corrección quirúrgica del origen anómalo de la coronaria izquierda en la arteria pulmonar.Material y métodosEntre febrero de 2000 y mayo de 2008 fueron operados 13 pacientes con este diagnóstico. Seis eran menores de 1 año; mediana: 2,5 años; rango: 45 días a 21 años. Antes de la cirugía, el 61% de los pacientes presentaban insuficiencia cardíaca, el 69% signos de infarto y el 84% cardiomegalia moderada a grave. La fracción de acortamiento promedio era del 26,07% y existía insuficiencia mitral moderada a grave en el 46% de los casos. El diagnóstico se confirmó por cateterismo en 11 pacientes.

SUMMARYBackgroundThe anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital heart defect that produces myocardial ischemia with left ventricular dysfunction and mitral regurgitation. The natural history of the disease has been modified by the current surgical techniques which establish a system with two coronary arteries.ObjectivesTo evaluate our experience with the surgical correction of the anomalous origin of the left coronary artery from the pulmonary artery.Material and MethodsA total of 13 patients underwent surgical repair of this condition from February 2000 to May 2008. Median age was 2.5 years; range 45 days to 21 years. Six patients were &lt;1 year old. Before surgery, 61% of patients presented congestive heart failure, 69% had signs of myocardial infarction and 84% moderate to severe heart enlargement. Average shortening fraction was 26.07% and 46% of patients had moderate to severe mitral regurgitation. The diagnosis was confirmed by coronary angiography in 11 patients.The Takeuchi procedure was performed in one patient and 12 patients underwent direct anastomosis of the anomalous left coronary artery directly to the aorta. One patient underwent mitral valve repair. Perfusion of the anomalous coronary artery and cardioplegia were provided via the pulmonary artery in six patients.ResultsAt present, after a mean follow-up of 74.76 months, mortality rate is 0%. None of the patients presented congestive heart failure at discharge. A reduction in cardiac size was observed in 9/11 patients. The average postoperative shortening fraction was 39.92%. A decrease in the severity of mitral regurgitation was observed in all patients with only one exception. None of the patients presented severe mitral regurgitation in the late postoperative period.ConclusionsThe outcomes of the surgical correction of the anomalous origin of the left main coronary artery from the pulmonary artery are excellent in all age groups, with significant improvement of myocardial function and reduction of the severity of mitral regurgitation in most patients

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 78, No 5 (2010); 411-416, Argentine Journal of Cardiology; Vol 78, No 5 (2010); 411-416

Citación

Lugones, Ignacio; Servicio de Cirugía Cardiovascular Pediátrica. Hospital de Niños “Dr. Ricardo Gutiérrez”. Buenos Aires, Argentina et al., “Origen anómalo de la coronaria izquierda en la arteria,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8029.

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Materia

Autor

Lugones, Ignacio; Servicio de Cirugía Cardiovascular Pediátrica. Hospital de Niños “Dr. Ricardo Gutiérrez”. Buenos Aires, Argentina
Kreutzer, Christian
Roman, Maria
Schlichter, Andres

Fuente

Revista Argentina de Cardiología; Vol 78, No 5 (2010); 411-416
Argentine Journal of Cardiology; Vol 78, No 5 (2010); 411-416

Editor

Sociedad Argentina de Cardiología

Fecha

2011-12-20

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Formato

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spa
eng

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion