Surgical repair of anomalous origin of the coronary artery from the pulmonary artery in children

Objective: To evaluate surgical management of children with coronary artery anomalies, including patients with rare abnormalities (left anterior desce nding artery or right coronary artery originating from the pulmonary artery ). Methods: A retrospective review of eight patients (aged 2 months-10 yr: med ian 3.5 yr), treated for coronary artery anomalies between 1989 and 1999. C oronary vessels were reimplanted to the aorta in four children, while the r emaining Pour were subjected to the Takeuchi procedure. Results: All children survived. None required mechanical circulatory suppor t. In six patients significant mitral valve insufficiency developed. nevert heless. no intraoperative mitral valvuloplasty was performed. Follow-up was 2 months-10 yr. All patients developed normally and are currently in NYHA class I. Echocardiography revealed normal FS and EF values within 1-17 mont hs postoperatively. Conclusions: In children with coronary artery anomalies, the best results a re achieved with an early diagnosis and aggressive management. In our opini on coronary vessel reimplantation and the Takeuchi procedure yields compara ble results. (C) 2001 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.