TY - JOUR
T1 - Anomalous left coronary artery from pulmonary artery repair
T2 - Outcomes from the European Congenital Heart Surgeons Association Database
AU - Triglia, Laura Torlai
AU - Guariento, Alvise
AU - Zanotto, Lorenza
AU - Zanotto, Lucia
AU - Cattapan, Claudia
AU - Hu, Renjie
AU - Zhang, Haibo
AU - Herbst, Claudia
AU - Hörer, Jurgen
AU - Sarris, George
AU - Ebels, Tjark
AU - Maruszewski, Bohdan
AU - Tobota, Zdzislaw
AU - Blitzer, David
AU - Lorenzoni, Giulia
AU - Bottigliengo, Daniele
AU - Gregori, Dario
AU - Padalino, Massimo
AU - Di Salvo, Giovanni
AU - Vida, Vladimiro L.
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2021/6
Y1 - 2021/6
N2 - Introduction: We sought to determine the surgical outcomes of patients with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) enrolled in the European Congenital Heart Surgeons Association (ECHSA) database. Materials and Methods: From 1999 to 2019, 907 patients with ALCAPA underwent surgical repair and were included in the current study. The primary outcome was in-hospital mortality. Secondary outcomes included frequency and results of concomitant mitral valve surgery and postoperative mechanical circulatory support (MCS). Results: The overall in-hospital mortality was 6% (54/907) and was significantly higher in neonates (p =.01), patients with lower body surface area (BSA) (p =.01), and those requiring postoperative MCS (p =.001). Associated mitral valve surgery was performed in 144 patients (15.9%) and was associated with longer cardiopulmonary bypass (CPB) and aortic cross-clamp times (AOX) (p ≤.0001) but was not significantly related to an increase in in-hospital mortality. Postoperative MCS was required in 66 patients (7.3%). These patients were younger (p ≤.001), had a lower BSA (p ≤.001), and required a longer CPB (p ≤.001) and AOX time (p ≤.001). Conclusions: ALCAPA repair can be achieved successfully, and with low surgical risk. Concomitant mitral valve procedures can be performed without increasing operative mortality. The use of MCS remains a valuable option, especially in younger patients.
AB - Introduction: We sought to determine the surgical outcomes of patients with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) enrolled in the European Congenital Heart Surgeons Association (ECHSA) database. Materials and Methods: From 1999 to 2019, 907 patients with ALCAPA underwent surgical repair and were included in the current study. The primary outcome was in-hospital mortality. Secondary outcomes included frequency and results of concomitant mitral valve surgery and postoperative mechanical circulatory support (MCS). Results: The overall in-hospital mortality was 6% (54/907) and was significantly higher in neonates (p =.01), patients with lower body surface area (BSA) (p =.01), and those requiring postoperative MCS (p =.001). Associated mitral valve surgery was performed in 144 patients (15.9%) and was associated with longer cardiopulmonary bypass (CPB) and aortic cross-clamp times (AOX) (p ≤.0001) but was not significantly related to an increase in in-hospital mortality. Postoperative MCS was required in 66 patients (7.3%). These patients were younger (p ≤.001), had a lower BSA (p ≤.001), and required a longer CPB (p ≤.001) and AOX time (p ≤.001). Conclusions: ALCAPA repair can be achieved successfully, and with low surgical risk. Concomitant mitral valve procedures can be performed without increasing operative mortality. The use of MCS remains a valuable option, especially in younger patients.
KW - congenital heart disease
KW - coronary arteries anomalies
KW - surgical outcomes
UR - http://www.scopus.com/inward/record.url?scp=85101867245&partnerID=8YFLogxK
U2 - 10.1111/jocs.15448
DO - 10.1111/jocs.15448
M3 - Article
C2 - 33651393
AN - SCOPUS:85101867245
SN - 0886-0440
VL - 36
SP - 1910
EP - 1916
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
IS - 6
ER -