22 results on '"coronary artery reimplantation"'
Search Results
2. Pre-operative evaluation and mid-term outcomes of anomalous origin of the left coronary artery from the pulmonary artery based on left ventricular ejection fraction
- Author
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Shu-Liang Xia, Hui-Kang Tao, Li Ma, Yan-Qing Cui, Ming-Hui Zou, Jian-Ru Li, Feng-xiang Li, Jia Li, Xu Zhang, and Xin-Xin Chen
- Subjects
anomalous left coronary artery originating from the pulmonary artery ,coronary artery reimplantation ,pre-operative evaluation ,effect ,infant ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
ObjectiveThe purpose of this study was to evaluate the prognosis of patients with anomalous left coronary artery originating from pulmonary artery with varying cardiac function after surgical correction.MethodsThis was a single-center retrospective cohort study including 51 patients with anomalous left coronary artery originating from pulmonary artery, all of whom underwent surgery at our center.ResultsAll 5 deaths occurred in the pre-operative low cardiac function group (n = 39). After corrected by body surface area, parameters such as left coronary artery, right coronary artery, left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and main pulmonary artery diameter, were lower in patients in the normal cardiac function group than in the low cardiac function group. The rate of collateral circulation formation was higher in the normal cardiac function group. The proportion of changes of T wave was higher in the low cardiac function group (P = 0.005), and the duration of vasoactive drugs (dopamine, milrinone, epinephrine, nitroglycerin.) was longer in the low cardiac function group. Left ventricular end-diastolic diameter, left ventricular end-systolic diameter, main pulmonary artery diameter, and left atrial diameter were smaller than those pre-operatively (P < 0.05). Left ventricular ejection fraction was higher than that pre-operatively (P = 0.003). The degree of mitral regurgitation in the low cardiac function group was reduced post-operatively (P < 0.001).ConclusionThere was a significant difference between the pre-operative baseline data of the low cardiac function group and the normal cardiac function group. After surgical repair, cardiac function gradually returned to normal in the low cardiac function group. The low cardiac function group required vasoactive drugs for a longer period of time. The left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left atrial diameter, and main pulmonary artery diameter decreased and gradually returned to normal after surgery. The degree of mitral regurgitation in the low cardiac function group was reduced after surgery.
- Published
- 2022
- Full Text
- View/download PDF
3. Corrigendum: Pre-operative evaluation and mid-term outcomes of anomalous origin of the left coronary artery from the pulmonary artery based on left ventricular ejection fraction.
- Author
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Xia SL, Tao HK, Ma L, Cui YQ, Zou MH, Li JR, Li FX, Li J, Zhang X, and Chen XX
- Abstract
[This corrects the article DOI: 10.3389/fcvm.2022.961491.]., (© 2024 Xia, Tao, Ma, Cui, Zou, Li, Li, Li, Zhang and Chen.)
- Published
- 2024
- Full Text
- View/download PDF
4. The role of exercise testing in congenital heart disease patients after coronary artery reimplantation
- Author
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Maëlle Chalverat, Judith Bouchardy, Coralie Blanche, Etienne Pruvot, Nicole Sekarski, Patrick Yerly, and Tobias Rutz
- Subjects
Ross procedure ,Arterial switch operation ,Coronary artery reimplantation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Introduction: The Ross procedure requires like the arterial switch operation (ASO) coronary artery reimplantation. There is no information on coronary artery stenosis at the site of the reimplantation in Ross patients as has been described for ASO patients. This study assessed therefore the prevalence of positive exercise tests (pETs) suggesting myocardial ischemia in Ross and ASO patients in comparison to tetralogy of Fallot patients (TOF), the latter not undergoing coronary artery reimplantation. The study evaluated further, whether a coronary artery complication was confirmed by a supplementary non- and/or invasive evaluation. Methods: Results of exercise tests, echocardiography, coronary computed tomography (CCT) and coronary angiography (CA) were retrospectively reviewed in 30 Ross, 14 ASO and 30 TOF patients. Results: Exercise capacity did not differ between groups. There was a trend to more frequent pETs in Ross patients (Ross vs. ASO vs. TOF, N, %): 8 (27) vs. 1 (7) vs. 2 (7) p = 0.062. CCT was performed in 30% Ross, 21% ASO, 3% TOF (p = 0.023); CA in 20% Ross, 21% ASO and 13% TOF patients (p = 0.727). None of these investigations revealed a coronary artery stenosis. Patients with pET showed a higher right ventricular outflow tract (RVOT) gradient (44 ± 30 vs. 22 ± 13 mmHg, p = 0.004) and more frequently a severe RVOT stenosis (27 vs. 0%, p
- Published
- 2021
- Full Text
- View/download PDF
5. The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation
- Author
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Kwang Ho Choi, Si Chan Sung, Hyungtae Kim, Hyoung Doo Lee, Hoon Ko, and Joung-Hee Byun
- Subjects
Arterial switch operation ,Coronary artery reimplantation ,Neoaortic reconstruction ,Surgery ,RD1-811 ,Anesthesiology ,RD78.3-87.3 - Abstract
Abstract Background The aim of this study was to determine if there was a difference between coronary reimplantation after neoaortic reconstruction and open coronary reimplantation technique in arterial switch operation (ASO). Methods A total of 236 patients who underwent ASO from March 1994 to August 2018 were enrolled in this study. Multivariate analysis was performed for postoperative early mortality. Patients were divided into the open coronary reimplantation and coronary reimplantation after neoaortic reconstruction groups. The 30-day mortality, intraoperative and postoperative coronary artery (CA) revisions, CA–related late morbidity and mortality, and early and late neoaortic valve regurgitations after ASO were compared between the two groups. Results Overall postoperative early mortality was 7.2% (17/236). Patients who underwent open coronary reimplantation had higher early mortality as compared with those who underwent coronary reimplantation after neoaortic reconstruction. Risk factors for postoperative early mortality from multivariate analysis were cardiopulmonary bypass time and open coronary reimplantation. There was a higher incidence of CA–related late mortality or morbidity in the open coronary reimplantation group. The open coronary reimplantation group had a higher incidence of intraoperative or postoperative CA revision. There were no differences in the incidence of mild or more neoaortic valve regurgitation at discharge or in the 5-year freedom from mild or more neoaortic valve regurgitation. Conclusions CA reimplantation after neoaortic reconstruction yields better results in mortality and intraoperative or postoperative CA–related problems in ASO without increasing postoperative neoaortic valve regurgitation.
- Published
- 2019
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6. Modified Closed Coronary Transfer is a Good Alternative to the Trap-Door Method During Arterial Switch Operation: a Retrospective Propensity-Matched Comparison.
- Author
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Dedemoğlu, Mehmet, Coşkun, Gültekin, Özdemir, Fatih, Yurdakök, Okan, Korun, Oktay, Çiçek, Murat, Biçer, Mehmet, Coşkun, Filiz İzgi, Aydemir, Numan Ali, and Şaşmazel, Ahmet
- Subjects
TRANSPORTATION of patients ,TRANSPOSITION of great vessels ,GLUCOSE clamp technique - Abstract
Objective: To compare the early and long-term results of patients in whom was performed modified closed coronary transfer with the results of patients in whom was performed trapdoor transfer techniques by utilizing propensity-matching analysis to provide optimal identical patient matching for the groups. Methods: From August 2015 to December 2017, 127 consecutive patients underwent arterial switch operation due to simple and complex transposition of the great arteries, with or without additional arch and complex coronary pattern, by a single surgical team included into the study. Of these, in 70 patients it was performed modified closed coronary transfer technique and in 57 patients it was performed trap-door style coronary transfer technique. The patients were divided into two groups in terms of coronary transfer method. In the final model, after propensity matching, 47 patients from each group having similar propensity score were included into the study. Results: There was no significant difference between the groups regarding patient characteristics. Cross-clamp time and operation time were significantly lower in the modified technique group compared with the other group (P=0.03 and P=0.05, respectively). When compared the early and late postoperative outcomes, there was no significant difference between the groups. Postoperative echocardiographic findings were mostly similar between the groups. Conclusion: The patients in whom was performed our modified technique demonstrate overall good outcomes and the current technique ensures shorter arterial cross-clamp and operation times. It may be an alternative method to the trap-door technique for the coronary transfer during the arterial switch operation. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
7. Levosimendan for Pediatric Anomalous Left Coronary Artery From the Pulmonary Artery Undergoing Repair: A Single-Center Experience
- Author
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Chunrong Wang, Junsong Gong, Sheng Shi, Jianhui Wang, Yuchen Gao, Sudena Wang, Yong G. Peng, Jing Song, and Yuefu Wang
- Subjects
levosimendan ,pediatric anomalous origin of the left coronary artery from the pulmonary artery ,coronary artery reimplantation ,left ventricular dysfunction ,postoperative outcomes ,Pediatrics ,RJ1-570 - Abstract
Objectives: Our aim was to retrospectively evaluate the benefit of levosimendan in certain complicated congenital heart procedures such as the pediatric anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) with moderate or severe cardiac dysfunction and its repair.Study Design: We enrolled 40 pediatric patients with ALCAPA and moderate or severe left ventricular dysfunction. Patients who had a preoperative left ventricular ejection fraction (LVEF) of 50% or less and had undergone the surgical correction of their coronary artery through cardiopulmonary bypass met the criteria of our study. Twenty patients were given 0.1–0.2 μg/kg/min levosimendan at the induction of anesthesia, which lasted for 24 h. The remaining 20 patients were not given levosimendan.Results: The mean preoperative LVEF in the levosimendan group was significantly lower than that in the non-levosimendan group (22.5 ± 10.7% vs. 31.8 ± 8.1%, p = 0.004). On postoperative day 7, the LVEF in the levosimendan group was still significantly lower (27.1 ± 8.9% vs. 37.5 ± 11.0%, p = 0.002). There was no significant difference in ΔLVEF detected on day 7 [median 30.8%, interquartile range (IQR) −4.4 to 63.5% vs. median 15.1%, IQR −3.5 to 40.0%, p = 0.560] or at follow-up of about 180 days (median 123.5%, IQR 56.1–222.6% vs. median 80.0%, IQR 36.4–131.3%, p = 0.064). There was no significant difference between the two groups in postoperative vasoactive-inotropic score (VIS) at any of the time points of 1, 6, 12, 24, and 48 h (p = 0.093). Three patients had to be supported by extracorporeal membrane oxygenation when difficulty appeared in weaning off cardiopulmonary bypass because of low cardiac output in the non-levosimendan group, but no patient needed extracorporeal membrane oxygenation after levosimendan infusion (p = 0.231). The length of intensive care unit stay (median 10.5 days, IQR 7.3–39.3 days vs. median 4.0 days, IQR 2.0–10.0 days, p = 0.002) and duration of mechanical ventilation (median 146.0 h, IQR 76.5–888.0 h vs. median 27.0 h, IQR 11.0–75.0 h, p = 0.002) were revealed to be longer in the levosimendan group. Peritoneal dialysis occurred in eight patients (40%) in the levosimendan group and two patients (10%) in the non-levosimendan group (p = 0.028). No significant difference was revealed in all-cause mortality within 180 days, which occurred in two patients (10%) in the levosimendan group and one (5%) in the non-levosimendan group (p = 1.00).Conclusion: Levosimendan's unique pharmacological properties have strong potential for cardiac function recovery among pediatric patients with ALCAPA with impaired left ventricular function who have undergone surgical repair.However, any improvement from levosimendan on postoperative outcomes or mortality was not substantiated by this study and must be investigated further.
- Published
- 2018
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8. Anomalous origin of the right coronary artery from the pulmonary artery. Two case reports
- Author
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K. Hakim, R. Boussaada, I. Hamdi, and Fatma Ouarda
- Subjects
Right coronary artery ,Pulmonary artery ,Coronary artery reimplantation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare but potentially fatal anomaly. We are presenting two cases of ARCAPA and reviewing the main previous published data on this lesion. The first patient presented at the age of 5 months with respiratory distress and severe chest infection. He was found to have heart murmur and cardiomegaly on chest X ray. Echocardiographic and angiographic data confirmed an ARCAPA associated to a large malalignment ventricular septal defect and distal pulmonary artery aneurysms. He underwent surgical closure of the ventricular septal defect and reimplantation of the ARCAPA on the aorta with good result. The second case is an 11 year old male patient, complaining of dizziness and chest pain on exertion. Echocardiographic and angiographic data confirmed ARCAPA associated to a valvular pulmonary stenosis. He was operated on successfully. He got also direct reimplantation of the anomalous coronary artery on the aorta and a pulmonary valve commissurotomy. An anomalous origin of the right coronary artery is a rare condition but may lead to myocardial ischemia and sudden death. Diagnosis is mainly made by echocardiography and confirmed by conventional coronary arteriography. Operative correction is the appropriate treatment for an anomalous coronary artery arising from the pulmonary trunk.
- Published
- 2014
- Full Text
- View/download PDF
9. Midterm outcome after surgical correction of anomalous left coronary artery from the pulmonary artery.
- Author
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Yunfei Ling, Bhushan, Sandeep, Qiang Fan, Menglin Tang, Ling, Yunfei, Fan, Qiang, and Tang, Menglin
- Subjects
- *
CORONARY disease , *MITRAL valve insufficiency , *CORONARY artery stenosis , *ECHOCARDIOGRAPHY , *PATIENTS , *CORONARY artery surgery , *PULMONARY artery , *CARDIOVASCULAR surgery , *TREATMENT effectiveness , *RETROSPECTIVE studies , *CORONARY angiography , *BLAND-White-Garland syndrome , *SURGERY ,PULMONARY artery diseases - Abstract
Background: This study was undertaken to determine the midterm outcome in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) undergoing coronary reimplantation and Takeuchi repair.Methods: A retrospective review of patients who had ALCAPA repair between January 2009 and December 2015. Mortality, echocardiography assessment of left ventricular function including ejection fractionand, shortening fraction, severity of mitral regurgitation, stenosis of the coronary ostium were studied retrospectively.Results: Sixteen patients were described. The mean age at the time of surgery was 22.5 ± 10.3 years (range, 9 months-35.6 years) and 2 patients were younger than 1 year old, Surgical interventions included left coronary artery reimplantation in 13 patients (81 %) and Takeuchi repair in 3 (19 %). Concomitant mitral valve repair was performed in 2 cases, no cases required mechanical circulatory support postoperatively. There was no mortality. At median follow-up of 4.6 years, EF improved from 33.2 % ±6.8 % to 60.9 % ± 8.1 % (p <0.05), mean SF from 28.5 % ± 12.1 % to 40.2 % ± 5.4 % (p <0.05). Only one patient was with moderate mitral regurgitation. All 16 cases had normal ejection fraction and shortening fraction without stenosis of the coronary ostium at last follow-up.Conclusions: Early establishment of a 2-coronary artery achieved excellent outcomes without morbidity and mechanical circulatory support. Normal ejection fraction and shortening fraction recovered smoothly. There is no stenosis of the coronary ostium at the midterm follow-up. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
10. The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation
- Author
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Joung-Hee Byun, Si Chan Sung, Kwang Ho Choi, Hyoung Doo Lee, Hoon Ko, and Hyung Tae Kim
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Cardiopulmonary bypass time ,Transposition of Great Vessels ,Arterial switch operation ,lcsh:Surgery ,030204 cardiovascular system & hematology ,Neoaortic reconstruction ,lcsh:RD78.3-87.3 ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,medicine ,Humans ,Postoperative Period ,Cardiac Surgical Procedures ,Aorta ,Neoaortic valve ,business.industry ,Incidence (epidemiology) ,Incidence ,Infant, Newborn ,Infant ,Heart ,General Medicine ,lcsh:RD1-811 ,Coronary Vessels ,Patient Discharge ,Surgery ,Cardiac surgery ,medicine.anatomical_structure ,030228 respiratory system ,Cardiothoracic surgery ,lcsh:Anesthesiology ,Replantation ,Multivariate Analysis ,Neoaortic valve regurgitation ,Female ,Cardiology and Cardiovascular Medicine ,business ,Coronary artery reimplantation ,Artery ,Research Article ,Follow-Up Studies - Abstract
Background The aim of this study was to determine if there was a difference between coronary reimplantation after neoaortic reconstruction and open coronary reimplantation technique in arterial switch operation (ASO). Methods A total of 236 patients who underwent ASO from March 1994 to August 2018 were enrolled in this study. Multivariate analysis was performed for postoperative early mortality. Patients were divided into the open coronary reimplantation and coronary reimplantation after neoaortic reconstruction groups. The 30-day mortality, intraoperative and postoperative coronary artery (CA) revisions, CA–related late morbidity and mortality, and early and late neoaortic valve regurgitations after ASO were compared between the two groups. Results Overall postoperative early mortality was 7.2% (17/236). Patients who underwent open coronary reimplantation had higher early mortality as compared with those who underwent coronary reimplantation after neoaortic reconstruction. Risk factors for postoperative early mortality from multivariate analysis were cardiopulmonary bypass time and open coronary reimplantation. There was a higher incidence of CA–related late mortality or morbidity in the open coronary reimplantation group. The open coronary reimplantation group had a higher incidence of intraoperative or postoperative CA revision. There were no differences in the incidence of mild or more neoaortic valve regurgitation at discharge or in the 5-year freedom from mild or more neoaortic valve regurgitation. Conclusions CA reimplantation after neoaortic reconstruction yields better results in mortality and intraoperative or postoperative CA–related problems in ASO without increasing postoperative neoaortic valve regurgitation.
- Published
- 2019
11. J
- Author
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De Cecco, Carlo Nicola, Rengo, Marco, De Cecco, Carlo N., Series editor, Laghi, Andrea, Series editor, De Cecco, Carlo Nicola, and Rengo, Marco
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- 2014
- Full Text
- View/download PDF
12. Anomalous origin of the right coronary artery from the pulmonary artery. Two case reports.
- Author
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Hakim, K., Boussaada, R., Hamdi, I., and Ouarda, Fatma
- Abstract
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare but potentially fatal anomaly. We are presenting two cases of ARCAPA and reviewing the main previous published data on this lesion. The first patient presented at the age of 5 months with respiratory distress and severe chest infection. He was found to have heart murmur and cardiomegaly on chest X ray. Echocardiographic and angiographic data confirmed an ARCAPA associated to a large malalignment ventricular septal defect and distal pulmonary artery aneurysms. He underwent surgical closure of the ventricular septal defect and reimplantation of the ARCAPA on the aorta with good result. The second case is an 11 year old male patient, complaining of dizziness and chest pain on exertion. Echocardiographic and angiographic data confirmed ARCAPA associated to a valvular pulmonary stenosis. He was operated on successfully. He got also direct reimplantation of the anomalous coronary artery on the aorta and a pulmonary valve commissurotomy. An anomalous origin of the right coronary artery is a rare condition but may lead to myocardial ischemia and sudden death. Diagnosis is mainly made by echocardiography and confirmed by conventional coronary arteriography. Operative correction is the appropriate treatment for an anomalous coronary artery arising from the pulmonary trunk. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
13. Modified Closed Coronary Transfer is a Good Alternative to the Trap-Door Method During Arterial Switch Operation: a Retrospective Propensity-Matched Comparison
- Author
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Okan Yurdakök, Filiz İzgi Coskun, Mehmet Biçer, Ahmet Şaşmazel, Fatih Özdemir, Numan Ali Aydemir, Mehmet Dedemoğlu, Murat Çiçek, Oktay Korun, and Gültekin Coşkun
- Subjects
Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Matching (statistics) ,medicine.medical_specialty ,Transposition of Great Vessels ,lcsh:Surgery ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Transfer (computing) ,Humans ,Medicine ,Propensity Score ,Transposition of great vessels ,Coronary Arteries ,Retrospective Studies ,Surgical team ,business.industry ,Significant difference ,Infant, Newborn ,Coronary Artery Reimplantation ,Trap door ,Heart ,lcsh:RD1-811 ,General Medicine ,Coronary Vessels ,Coronary arteries ,Arterial Switch Operation ,medicine.anatomical_structure ,lcsh:RC666-701 ,Great arteries ,Echocardiography ,Propensity score matching ,Cardiology ,Female ,Original Article ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective: To compare the early and long-term results of patients in whom was performed modified closed coronary transfer with the results of patients in whom was performed trap-door transfer techniques by utilizing propensity-matching analysis to provide optimal identical patient matching for the groups. Methods: From August 2015 to December 2017, 127 consecutive patients underwent arterial switch operation due to simple and complex transposition of the great arteries, with or without additional arch and complex coronary pattern, by a single surgical team included into the study. Of these, in 70 patients it was performed modified closed coronary transfer technique and in 57 patients it was performed trap-door style coronary transfer technique. The patients were divided into two groups in terms of coronary transfer method. In the final model, after propensity matching, 47 patients from each group having similar propensity score were included into the study. Results: There was no significant difference between the groups regarding patient characteristics. Cross-clamp time and operation time were significantly lower in the modified technique group compared with the other group (P=0.03 and P=0.05, respectively). When compared the early and late postoperative outcomes, there was no significant difference between the groups. Postoperative echocardiographic findings were mostly similar between the groups. Conclusion: The patients in whom was performed our modified technique demonstrate overall good outcomes and the current technique ensures shorter arterial cross-clamp and operation times. It may be an alternative method to the trap-door technique for the coronary transfer during the arterial switch operation.
- Published
- 2020
14. Pre-operative evaluation and mid-term outcomes of anomalous origin of the left coronary artery from the pulmonary artery based on left ventricular ejection fraction.
- Author
-
Xia SL, Tao HK, Ma L, Cui YQ, Zou MH, Li JR, Li FX, Li J, Zhang X, and Chen XX
- Abstract
Objective: The purpose of this study was to evaluate the prognosis of patients with anomalous left coronary artery originating from pulmonary artery with varying cardiac function after surgical correction., Methods: This was a single-center retrospective cohort study including 51 patients with anomalous left coronary artery originating from pulmonary artery, all of whom underwent surgery at our center., Results: All 5 deaths occurred in the pre-operative low cardiac function group ( n = 39). After corrected by body surface area, parameters such as left coronary artery, right coronary artery, left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and main pulmonary artery diameter, were lower in patients in the normal cardiac function group than in the low cardiac function group. The rate of collateral circulation formation was higher in the normal cardiac function group. The proportion of changes of T wave was higher in the low cardiac function group ( P = 0.005), and the duration of vasoactive drugs (dopamine, milrinone, epinephrine, nitroglycerin.) was longer in the low cardiac function group. Left ventricular end-diastolic diameter, left ventricular end-systolic diameter, main pulmonary artery diameter, and left atrial diameter were smaller than those pre-operatively ( P < 0.05). Left ventricular ejection fraction was higher than that pre-operatively ( P = 0.003). The degree of mitral regurgitation in the low cardiac function group was reduced post-operatively ( P < 0.001)., Conclusion: There was a significant difference between the pre-operative baseline data of the low cardiac function group and the normal cardiac function group. After surgical repair, cardiac function gradually returned to normal in the low cardiac function group. The low cardiac function group required vasoactive drugs for a longer period of time. The left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left atrial diameter, and main pulmonary artery diameter decreased and gradually returned to normal after surgery. The degree of mitral regurgitation in the low cardiac function group was reduced after surgery., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Xia, Tao, Ma, Cui, Zou, Li, Li, Li, Zhang and Chen.)
- Published
- 2022
- Full Text
- View/download PDF
15. The role of exercise testing in congenital heart disease patients after coronary artery reimplantation
- Author
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Patrick Yerly, Maëlle Chalverat, Etienne Pruvot, Coralie Blanche, Judith Bouchardy, Tobias Rutz, and N. Sekarski
- Subjects
medicine.medical_specialty ,Heart disease ,business.industry ,Ross procedure ,medicine.medical_treatment ,Arterial switch operation ,medicine.disease ,Coronary computed tomography ,Stenosis ,medicine.anatomical_structure ,RC666-701 ,Internal medicine ,parasitic diseases ,medicine ,Cardiology ,Diseases of the circulatory (Cardiovascular) system ,Ventricular outflow tract ,business ,Complication ,Coronary artery reimplantation ,Tetralogy of Fallot ,Artery - Abstract
Introduction The Ross procedure requires like the arterial switch operation (ASO) coronary artery reimplantation. There is no information on coronary artery stenosis at the site of the reimplantation in Ross patients as has been described for ASO patients. This study assessed therefore the prevalence of positive exercise tests (pETs) suggesting myocardial ischemia in Ross and ASO patients in comparison to tetralogy of Fallot patients (TOF), the latter not undergoing coronary artery reimplantation. The study evaluated further, whether a coronary artery complication was confirmed by a supplementary non- and/or invasive evaluation. Methods Results of exercise tests, echocardiography, coronary computed tomography (CCT) and coronary angiography (CA) were retrospectively reviewed in 30 Ross, 14 ASO and 30 TOF patients. Results Exercise capacity did not differ between groups. There was a trend to more frequent pETs in Ross patients (Ross vs. ASO vs. TOF, N, %): 8 (27) vs. 1 (7) vs. 2 (7) p = 0.062. CCT was performed in 30% Ross, 21% ASO, 3% TOF (p = 0.023); CA in 20% Ross, 21% ASO and 13% TOF patients (p = 0.727). None of these investigations revealed a coronary artery stenosis. Patients with pET showed a higher right ventricular outflow tract (RVOT) gradient (44 ± 30 vs. 22 ± 13 mmHg, p = 0.004) and more frequently a severe RVOT stenosis (27 vs. 0%, p Conclusions pETs are rather related to RVOT stenosis than to coronary artery complications after Ross procedure, ASO and TOF repair. The role of exercise testing for detection of myocardial ischemia is limited and should be restricted to evaluation of exercise capacity.
- Published
- 2021
16. The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation
- Author
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Choi, Kwang Ho, Sung, Si Chan, Kim, Hyungtae, Lee, Hyoung Doo, Ko, Hoon, and Byun, Joung-Hee
- Published
- 2019
- Full Text
- View/download PDF
17. Anomalous origin of the right coronary artery from the pulmonary artery. Two case reports
- Author
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Rafik Boussaada, Khaouther Hakim, I. Hamdi, and Fatma Ouarda
- Subjects
Right coronary artery ,medicine.medical_specialty ,Aorta ,lcsh:Diseases of the circulatory (Cardiovascular) system ,business.industry ,Chest pain ,Sudden death ,Pulmonary artery ,medicine.anatomical_structure ,lcsh:RC666-701 ,Internal medicine ,Pulmonary valve ,medicine.artery ,medicine ,Cardiology ,Heart murmur ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Commissurotomy ,business ,Coronary artery reimplantation - Abstract
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare but potentially fatal anomaly. We are presenting two cases of ARCAPA and reviewing the main previous published data on this lesion. The first patient presented at the age of 5 months with respiratory distress and severe chest infection. He was found to have heart murmur and cardiomegaly on chest X ray. Echocardiographic and angiographic data confirmed an ARCAPA associated to a large malalignment ventricular septal defect and distal pulmonary artery aneurysms. He underwent surgical closure of the ventricular septal defect and reimplantation of the ARCAPA on the aorta with good result. The second case is an 11 year old male patient, complaining of dizziness and chest pain on exertion. Echocardiographic and angiographic data confirmed ARCAPA associated to a valvular pulmonary stenosis. He was operated on successfully. He got also direct reimplantation of the anomalous coronary artery on the aorta and a pulmonary valve commissurotomy. An anomalous origin of the right coronary artery is a rare condition but may lead to myocardial ischemia and sudden death. Diagnosis is mainly made by echocardiography and confirmed by conventional coronary arteriography. Operative correction is the appropriate treatment for an anomalous coronary artery arising from the pulmonary trunk.
- Published
- 2014
- Full Text
- View/download PDF
18. Modified Closed Coronary Transfer is a Good Alternative to the Trap-Door Method During Arterial Switch Operation: a Retrospective Propensity-Matched Comparison
- Author
-
Mehmet Dedemoğlu, Gültekin Coşkun, Fatih Özdemir, Okan Yurdakök, Oktay Korun, Murat Çiçek, Mehmet Biçer, Filiz İzgi Coşkun, Numan Ali Aydemir, and Ahmet Şaşmazel
- Subjects
arterial switch operation ,coronary arteries ,coronary artery reimplantation ,propensity score ,transposition of great vessels ,heart ,echocardiography ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Objective: To compare the early and long-term results of patients in whom was performed modified closed coronary transfer with the results of patients in whom was performed trap-door transfer techniques by utilizing propensity-matching analysis to provide optimal identical patient matching for the groups. Methods: From August 2015 to December 2017, 127 consecutive patients underwent arterial switch operation due to simple and complex transposition of the great arteries, with or without additional arch and complex coronary pattern, by a single surgical team included into the study. Of these, in 70 patients it was performed modified closed coronary transfer technique and in 57 patients it was performed trap-door style coronary transfer technique. The patients were divided into two groups in terms of coronary transfer method. In the final model, after propensity matching, 47 patients from each group having similar propensity score were included into the study. Results: There was no significant difference between the groups regarding patient characteristics. Cross-clamp time and operation time were significantly lower in the modified technique group compared with the other group (P=0.03 and P=0.05, respectively). When compared the early and late postoperative outcomes, there was no significant difference between the groups. Postoperative echocardiographic findings were mostly similar between the groups. Conclusion: The patients in whom was performed our modified technique demonstrate overall good outcomes and the current technique ensures shorter arterial cross-clamp and operation times. It may be an alternative method to the trap-door technique for the coronary transfer during the arterial switch operation.
- Full Text
- View/download PDF
19. Levosimendan for Pediatric Anomalous Left Coronary Artery From the Pulmonary Artery Undergoing Repair: A Single-Center Experience.
- Author
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Wang C, Gong J, Shi S, Wang J, Gao Y, Wang S, Peng YG, Song J, and Wang Y
- Abstract
Objectives: Our aim was to retrospectively evaluate the benefit of levosimendan in certain complicated congenital heart procedures such as the pediatric anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) with moderate or severe cardiac dysfunction and its repair. Study Design: We enrolled 40 pediatric patients with ALCAPA and moderate or severe left ventricular dysfunction. Patients who had a preoperative left ventricular ejection fraction (LVEF) of 50% or less and had undergone the surgical correction of their coronary artery through cardiopulmonary bypass met the criteria of our study. Twenty patients were given 0.1-0.2 μg/kg/min levosimendan at the induction of anesthesia, which lasted for 24 h. The remaining 20 patients were not given levosimendan. Results: The mean preoperative LVEF in the levosimendan group was significantly lower than that in the non-levosimendan group (22.5 ± 10.7% vs. 31.8 ± 8.1%, p = 0.004). On postoperative day 7, the LVEF in the levosimendan group was still significantly lower (27.1 ± 8.9% vs. 37.5 ± 11.0%, p = 0.002). There was no significant difference in ΔLVEF detected on day 7 [median 30.8%, interquartile range (IQR) -4.4 to 63.5% vs. median 15.1%, IQR -3.5 to 40.0%, p = 0.560] or at follow-up of about 180 days (median 123.5%, IQR 56.1-222.6% vs. median 80.0%, IQR 36.4-131.3%, p = 0.064). There was no significant difference between the two groups in postoperative vasoactive-inotropic score (VIS) at any of the time points of 1, 6, 12, 24, and 48 h ( p = 0.093). Three patients had to be supported by extracorporeal membrane oxygenation when difficulty appeared in weaning off cardiopulmonary bypass because of low cardiac output in the non-levosimendan group, but no patient needed extracorporeal membrane oxygenation after levosimendan infusion ( p = 0.231). The length of intensive care unit stay (median 10.5 days, IQR 7.3-39.3 days vs. median 4.0 days, IQR 2.0-10.0 days, p = 0.002) and duration of mechanical ventilation (median 146.0 h, IQR 76.5-888.0 h vs. median 27.0 h, IQR 11.0-75.0 h, p = 0.002) were revealed to be longer in the levosimendan group. Peritoneal dialysis occurred in eight patients (40%) in the levosimendan group and two patients (10%) in the non-levosimendan group ( p = 0.028). No significant difference was revealed in all-cause mortality within 180 days, which occurred in two patients (10%) in the levosimendan group and one (5%) in the non-levosimendan group ( p = 1.00). Conclusion: Levosimendan's unique pharmacological properties have strong potential for cardiac function recovery among pediatric patients with ALCAPA with impaired left ventricular function who have undergone surgical repair.However, any improvement from levosimendan on postoperative outcomes or mortality was not substantiated by this study and must be investigated further.
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- 2018
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20. Midterm outcome after surgical correction of anomalous left coronary artery from the pulmonary artery.
- Author
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Ling Y, Bhushan S, Fan Q, and Tang M
- Subjects
- Adolescent, Adult, Bland White Garland Syndrome physiopathology, Cardiovascular Surgical Procedures methods, Child, Child, Preschool, Coronary Angiography, Coronary Vessels surgery, Echocardiography, Female, Humans, Infant, Male, Pulmonary Artery surgery, Retrospective Studies, Treatment Outcome, Young Adult, Bland White Garland Syndrome surgery
- Abstract
Background: This study was undertaken to determine the midterm outcome in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) undergoing coronary reimplantation and Takeuchi repair., Methods: A retrospective review of patients who had ALCAPA repair between January 2009 and December 2015. Mortality, echocardiography assessment of left ventricular function including ejection fractionand, shortening fraction, severity of mitral regurgitation, stenosis of the coronary ostium were studied retrospectively., Results: Sixteen patients were described. The mean age at the time of surgery was 22.5 ± 10.3 years (range, 9 months-35.6 years) and 2 patients were younger than 1 year old, Surgical interventions included left coronary artery reimplantation in 13 patients (81 %) and Takeuchi repair in 3 (19 %). Concomitant mitral valve repair was performed in 2 cases, no cases required mechanical circulatory support postoperatively. There was no mortality. At median follow-up of 4.6 years, EF improved from 33.2 % ±6.8 % to 60.9 % ± 8.1 % (p <0.05), mean SF from 28.5 % ± 12.1 % to 40.2 % ± 5.4 % (p <0.05). Only one patient was with moderate mitral regurgitation. All 16 cases had normal ejection fraction and shortening fraction without stenosis of the coronary ostium at last follow-up., Conclusions: Early establishment of a 2-coronary artery achieved excellent outcomes without morbidity and mechanical circulatory support. Normal ejection fraction and shortening fraction recovered smoothly. There is no stenosis of the coronary ostium at the midterm follow-up.
- Published
- 2016
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21. The trap-door technique for coronary reimplantation in aortic root surgery.
- Author
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Mariani S, Thomas LH, and Peek GJ
- Subjects
- Adolescent, Adult, Child, Female, Humans, Male, Middle Aged, Young Adult, Aneurysm, False surgery, Aorta, Thoracic surgery, Aortic Aneurysm, Thoracic surgery, Coronary Vessels surgery, Replantation methods, Vascular Surgical Procedures methods
- Abstract
Coronary ostia reimplantation is a crucial stage of every aortic root replacement procedure. The 'button technique' is currently the most used method and it has shown satisfactory outcomes over time. However, coronary reimplantation techniques still present drawbacks such as pseudoaneurysm formation, kinking, bleeding and coronary dehiscence, especially when coronaries are hard to mobilize. We adapted the trap-door technique, commonly used in the arterial switch operations, in order to apply it in older patients requiring an aortic root replacement procedure. The key passage of such a technique is the creation of an L-shaped trap-door flap in the conduit graft in order to produce a cone-like extension of the conduit from which the coronary ostium can arise. We applied this technique in 24 patients over 8 years and we did not experience any complication related to coronary ostia reimplantation. In conclusion, we think that this method could be considered as an alternative technique in order to avoid the use of an interposition vascular graft or a pericardial patch when the conventional reimplantation techniques are not feasible., (© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
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- 2016
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22. Midterm outcome after surgical correction of anomalous left coronary artery from the pulmonary artery
- Author
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Menglin Tang, Yunfei Ling, Sandeep Bhushan, and Qiang Fan
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Pulmonary Artery ,030204 cardiovascular system & hematology ,Coronary Angiography ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Left coronary artery ,medicine.artery ,Internal medicine ,Bland White Garland Syndrome ,medicine ,Humans ,Child ,Outcome ,Retrospective Studies ,Mitral regurgitation ,Mitral valve repair ,Ejection fraction ,business.industry ,Cardiovascular Surgical Procedures ,Infant ,Anomalous coronary artery from pulmonary artery ,General Medicine ,Surgical correction ,medicine.disease ,Coronary Vessels ,Cardiac surgery ,Stenosis ,Treatment Outcome ,030228 respiratory system ,Echocardiography ,Cardiothoracic surgery ,Child, Preschool ,Pulmonary artery ,Cardiology ,Female ,Surgery ,business ,Cardiology and Cardiovascular Medicine ,Coronary artery reimplantation ,Research Article - Abstract
Background This study was undertaken to determine the midterm outcome in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) undergoing coronary reimplantation and Takeuchi repair. Methods A retrospective review of patients who had ALCAPA repair between January 2009 and December 2015. Mortality, echocardiography assessment of left ventricular function including ejection fractionand, shortening fraction, severity of mitral regurgitation, stenosis of the coronary ostium were studied retrospectively. Results Sixteen patients were described. The mean age at the time of surgery was 22.5 ± 10.3 years (range, 9 months-35.6 years) and 2 patients were younger than 1 year old, Surgical interventions included left coronary artery reimplantation in 13 patients (81 %) and Takeuchi repair in 3 (19 %). Concomitant mitral valve repair was performed in 2 cases, no cases required mechanical circulatory support postoperatively. There was no mortality. At median follow-up of 4.6 years, EF improved from 33.2 % ±6.8 % to 60.9 % ± 8.1 % (p
- Full Text
- View/download PDF
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