https://scholars.lib.ntu.edu.tw/handle/123456789/469631
標題: | Resolution of pathologic Q wave, left ventricular dysfunction and mitral regurgitation after dual coronary repair of the anomalous origin of the left coronary artery from the pulmonary artery | 作者: | Chiu H.-H. JOU-KOU WANG CHUN-AN CHEN SHUENN-NAN CHIU MING-TAI LIN Lue H.-C. CHUNG-I CHANG ING-SH CHIU MEI-HWAN WU |
公開日期: | 2008 | 卷: | 167 | 期: | 11 | 起(迄)頁: | 1277-1282 | 來源出版物: | European Journal of Pediatrics | 摘要: | Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac defect that usually presents as dilated cardiomyopathy in infancy. From 1984 to 2005, 13 (five males and eight females, 0.13%) out of 9,950 patients with congenital heart disease were identified as ALCAPA at our institute. Corrective surgery was performed at a median age of 9 months (range: 2 months to 5 years). Eleven patients underwent direct reimplantation of the left coronary artery (LCA) to the aorta, while two received extrapulmonary baffling. The overall survival rate was 92%. Only one patient died 5 months after reimplantation of the LCA due to acute myocardial ischaemia. Left ventricular ejection fraction (LVEF) was significantly lower in the eight (62%) patients operated during infancy than in those operated beyond 5 months (median: 35% vs. 75%). Left ventricle function was normalised in 11 patients (85%). Among the eight patients without concomitant mitral annuloplasty, mitral regurgitation (MR) improved to a mild or trivial degree in six patients and remained at the pre-operative level in two patients. Pathologic Q wave was noted in 11 patients, which eventually regressed in all except two cases. The median interval of recovery was 16 days, 6 months and 24 months for MR, LVEF and electrocardiogram (ECG) changes, respectively. In conclusion, ALCAPA is also a rare disease in Asian countries, such as Taiwan. The subsequent recovery of MR, left ventricular (LV) function and even pathologic Q wave can be expected after dual coronary repair, regardless of the age at repair. ? 2008 Springer-Verlag. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-51849109124&doi=10.1007%2fs00431-008-0667-4&partnerID=40&md5=6e4c98edd7e9d71a337ea7562294466a https://scholars.lib.ntu.edu.tw/handle/123456789/469631 |
ISSN: | 0340-6199 | DOI: | 10.1007/s00431-008-0667-4 | SDG/關鍵字: | anomalous origin of the left coronary artery from the pulmonary artery; article; Asian; child; clinical article; congenital heart malformation; controlled study; electrocardiogram; female; groups by age; heart left ventricle ejection fraction; heart left ventricle failure; heart left ventricle function; human; left coronary artery; male; mitral annuloplasty; mitral valve regurgitation; mortality; plastic surgery; preoperative period; priority journal; pulmonary artery; Q wave; reimplantation; survival; Taiwan; Child; Child, Preschool; Coronary Vessels; Echocardiography; Electrocardiography; Female; Follow-Up Studies; Humans; Infant; Long QT Syndrome; Male; Mitral Valve Insufficiency; Postoperative Complications; Preoperative Care; Pulmonary Artery; Severity of Illness Index; Ventricular Dysfunction, Left |
顯示於: | 醫學系 |
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