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Anomalous left coronary arter from pulmonary trunk. Long-term follow-up after ligation
Insights
Long-term follow-up shows ligation of anomalous left coronary artery is safe and effective. Patients remain asymptomatic, with improved cardiac size, though some electrocardiogram abnormalities persist, especially in those operated on in infancy.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Congenital Heart Disease
Background:
- Anomalous left coronary artery (ALCA) is a rare congenital heart defect.
- Surgical ligation is a treatment option for ALCA.
- Long-term outcomes after ALCA ligation are not well-established.
Purpose of the Study:
- To report the long-term clinical outcomes of patients who underwent ligation of anomalous left coronary artery.
- To assess the impact of age at surgery on long-term results.
Main Methods:
- Retrospective case series of four patients with ALCA.
- Surgical ligation of the anomalous left coronary artery.
- Long-term follow-up including clinical assessment, chest roentgenogram, electrocardiogram (ECG), and treadmill exercise testing.
Main Results:
- All four patients were asymptomatic with good clinical status at 10-13 years post-surgery.
- Cardiac size normalized on chest roentgenograms.
- Electrocardiogram abnormalities persisted in all patients.
- Patients operated on in infancy had abnormal ECG findings during treadmill exercise, unlike those operated on later.
Conclusions:
- Ligation of anomalous left coronary artery provides good long-term clinical outcomes.
- Age at surgery may influence the persistence of exercise-induced electrocardiographic abnormalities.
- Further research is needed to fully understand the long-term implications of ALCA ligation.
Abstract:
Long-term follow-up (10 to 13 years) of four patients with anomalous left coronary artery who underwent ligation of the anomalous left coronary artery is presented. Two were operated upon in infancy and the other two at 6 and 7 years of age, respectively. Postoperatively, each is asymptomatic and doing well clinically. The cardiac size on roentgenogram of the chest returned toward normal in each. Abnormalities persist on the electrocardiogram. On treadmill exercise, the electrocardiogram of the two operated upon in infancy showed an abnormal result, whereas the two patients operated upon later in childhood had no electrocardiographic abnormalities.