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Anatomical reconstruction of proximal coronary artery stenosis in children.
Krokovay, A; Prêtre, R; Kretschmar, O; Knirsch, W; Valsangiacomo Buechel, E; Dave, H.
Afiliación
  • Krokovay A; Division of Congenital Cardiovascular Surgery, Paediatric Heart Centre, Children's Research Centre, University Children's Hospital, University of Zurich, Zurich, Switzerland.
  • Prêtre R; Division of Cardiac Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Kretschmar O; Division of Paediatric Cardiology, Paediatric Heart Centre, Children's Research Centre, University Children's Hospital, University of Zurich, Zurich, Switzerland.
  • Knirsch W; Division of Paediatric Cardiology, Paediatric Heart Centre, Children's Research Centre, University Children's Hospital, University of Zurich, Zurich, Switzerland.
  • Valsangiacomo Buechel E; Division of Paediatric Cardiology, Paediatric Heart Centre, Children's Research Centre, University Children's Hospital, University of Zurich, Zurich, Switzerland.
  • Dave H; Division of Congenital Cardiovascular Surgery, Paediatric Heart Centre, Children's Research Centre, University Children's Hospital, University of Zurich, Zurich, Switzerland.
Eur J Cardiothorac Surg ; 62(3)2022 08 03.
Article en En | MEDLINE | ID: mdl-35551375
OBJECTIVES: Timing and method of surgical reconstruction for non-sclerotic proximal coronary artery stenosis, occurring de novo or post-coronary artery transfer, are evolving. We have pursued a technique of anatomical reconstruction of ostial and short segment proximal coronary artery stenosis and atresia in children, using patch plasty or interposition vein graft. Here, we discuss the medium- to long-term outcomes. METHODS: Nine consecutive children undergoing 10 left main coronary artery reconstructions using autologous great saphenous vein patch (n = 4), autologous pericardium (n = 4), xenopericardium (n = 1) or great saphenous vein interposition graft (n = 1) were retrospectively analysed. Complementary wedge resection of the stenotic coronary ostium was performed in chronic cases. RESULTS: The aetiology of coronary artery stenosis was post-arterial switch operation (n = 6), Takayasu's arteritis (n = 1), idiopathic left main coronary artery atresia (n = 1) and anomalous origin of the left coronary artery from the pulmonary artery (n = 1). The median age and weight at operation were 0.15 (range 0.01-13.1) years and 4.4 (range 3-13.1) kg, respectively. Survival was 100% at the medi follow-up of 12.6 (range 1-19.2) years. All patients showed normal left ventricular ejection fraction on transthoracic echocardiogram. In 1 patient, kinking of the proximal left circumflex artery resulted in non-significant obstruction. In all other cases, follow-up catheter angiography revealed unobstructed coronary arteries. Cardiac magnetic resonance tomography showed no significant perfusion deficit in any child. CONCLUSIONS: Anatomical reconstruction of the proximal left coronary artery using autologous saphenous vein may allow optimal restoration of physiological coronary blood flow, keeping the option of future coronary bypass operation open.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Función Ventricular Izquierda / Estenosis Coronaria Tipo de estudio: Observational_studies Límite: Adolescent / Child / Child, preschool / Humans / Infant / Newborn Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Función Ventricular Izquierda / Estenosis Coronaria Tipo de estudio: Observational_studies Límite: Adolescent / Child / Child, preschool / Humans / Infant / Newborn Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Alemania