Surgical intervention for anomalous origin of the left coronary artery from the pulmonary artery: The Tokyo experience  Yukihisa Isomatsu, MD, Yasuharu.

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Presentation transcript:

Surgical intervention for anomalous origin of the left coronary artery from the pulmonary artery: The Tokyo experience  Yukihisa Isomatsu, MD, Yasuharu Imai, MD, Toshiharu Shin'oka, MD, Mitsuru Aoki, MD, Yusuke Iwata, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 121, Issue 4, Pages 792-797 (April 2001) DOI: 10.1067/mtc.2001.112834 Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Mitral annuloplasty at the anterolateral commissure with polytetrafluoroethylene sutures. The Journal of Thoracic and Cardiovascular Surgery 2001 121, 792-797DOI: (10.1067/mtc.2001.112834) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 A, Semicircular annuloplasty with absorbable suture was done in a 10-month-old infant. B, A 5-year-old patient with another commissure at the middle of the posterior leaflet had commissure plasty approximated with 6 interrupted sutures. C, In a 2.5-year-old boy there was severe prolapse of both the anterior and posterior leaflets and anomalous independent posterior papillary muscle, which sent 3 short thickened chordae to the medial portion of the anterior leaflet. A rectangular piece of the posterior leaflet between the first and fourth chordae of the anterior papillary muscle was resected, and the defect was approximated with 4 interrupted sutures, with pericardial tape as reinforcement. The corresponding amount of anterior leaflet was corrugated and buttressed with 5 sutures in the same manner. Chordae from the anterior papillary muscle was finally included in this valvuloplasty. Circular annuloplasty was performed to reduce its orifice to No. 16 Hegar's dilator. *Anomalous posterior papillary muscle. The Journal of Thoracic and Cardiovascular Surgery 2001 121, 792-797DOI: (10.1067/mtc.2001.112834) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Trend in the CTRs of survivors at each time point. Values are expressed as means ± SD. *P =.005 and **P =.003 versus preoperative CTR. The Journal of Thoracic and Cardiovascular Surgery 2001 121, 792-797DOI: (10.1067/mtc.2001.112834) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Changes in the FSz at specific time points for patients with echocardiograms. Values are represented as z-scores and means ± SD. *P =.003 versus FSz value at the time of discharge. Dotted lines indicate z-scores of ± 2. The Journal of Thoracic and Cardiovascular Surgery 2001 121, 792-797DOI: (10.1067/mtc.2001.112834) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Improvement of the degree of mitral incompetence in 22 survivors with annuloplasty. The number in each square is the number of patients who had that degree of incompetence at that time. Five patients who had no preoperative incompetence are not shown. MVR, Mitral valve replacement. The Journal of Thoracic and Cardiovascular Surgery 2001 121, 792-797DOI: (10.1067/mtc.2001.112834) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions