Abstract：Objective To summarize the surgical results of anomalous left coronary artery from the pulmonary artery (ALCAPA) in children. Methods A retrospective study of nine cases of pediatric ALCAPA who were admitted to TEDA International Cardiovascular Hospital between February 2015 and October 2020 was conducted. The patients included two males and seven females with a range age of 0.2–12.3 years (median 1.7 years) and a range body mass of 5.7–44.3 kg (median 11.6 kg). Patients were treated with individualized surgical strategies (Takeuchi, Flap-to-flap, Tanslocation, Ostioplasty) to restore dual-source coronary artery blood supply, 4 patients underwent concomitant mitral valvuloplasty. The degree of left ventricular ejection fraction (LVEF) and mitral valve regurgitation were monitored, and changes in the two indicators were compared before surgery, in the early postoperative period, and at the last follow-up. Results All patients were operated successfully without death. Two severely infants had delayed chest closure after operation. All patients were followed up for 1 month to 4.5 years after discharge, and no angina or heart failure was found. The LVEF in the early postoperative and preoperative periods were 62.1% (39.0%, 63.5%) and 59.0% (40.0%, 64.5%), respectively, with no significant difference (Z=14.00, P=1.000); LVEF at the last follow-up was 64.0% (60.5%, 67.5%), which was significantly improved compared with that in the early postoperative period (Z=26.50, P=0.034). Early postoperative mitral value regurgitation had no significant difference compared with preoperative and final follow-up mitral value regurgitation (Z=1.13, 1.41; P=0.257, 0.157). Conclusion Satisfactory short- and medium-term results can be achieved through surgery in children with ALCAPA.
薛兰钢, 路万里, 刘金松, 陈万兴, 王秀丽, 李鑫, 张颖, 黄辉, 刘志刚. 小儿左冠状动脉异常起源于肺动脉的外科矫治[J]. 中华解剖与临床杂志, 2022, 27(3): 169-174.
Xue Langang, Lu Wanli, Liu Jinsong, Chen Wanxing, Wang Xiuli, Li Xin, Zhang Ying, Huang Hui, Liu Zhigang. Surgical treatment of anomalous left coronary artery from the pulmonary artery in children. Chinese Journal of Anatomy and Clinics, 2022, 27(3): 169-174.
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2022, Vol. 27 
