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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

[Profil and course of complete obstruction of 3 coronary trunks]

D P Crochet, L Campeau, J Saltiel

    Archives Des Maladies Du Coeur Et Des Vaisseaux
    |July 1, 1975
    PubMed

    Insights

    Patients with complete obstruction of three major coronary arteries have a poor prognosis. Early surgical intervention is recommended for significant three-vessel coronary artery disease to improve survival rates.

    Area of Science:

    • Cardiology
    • Vascular Surgery

    Context:

    • Coronary arteriography identified 12 patients (0.3%) with complete obstruction of three major coronary arteries.
    • Clinical presentations varied, with many not exhibiting typical angina or dyspnea despite previous myocardial infarction or heart failure.

    Purpose:

    • To evaluate the clinical manifestations, outcomes, and treatment efficacy for patients with complete three-vessel coronary artery obstruction.

    Summary:

    • Resting EKGs were abnormal in most patients, and half had elevated end-diastolic pressure and impaired left ventricular contraction.
    • Surgery in 7 patients resulted in one operative death, but a 20% yearly mortality rate was observed over 3 years.
    • This high mortality and functional impairment suggest considering surgery before complete obstruction in significant three-vessel coronary artery disease.

    Impact:

    • The findings underscore the critical need for timely surgical intervention in patients with severe three-vessel coronary artery disease to enhance long-term survival.
    • A 10% yearly mortality rate in triple vessel obstruction cases further supports surgical consideration, contingent on good distal runoff and left ventricular function.

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