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Anomalies of Left Coronary Artery Origin Affecting Surgical Repair of Hypoplastic Left Heart Syndrome and Shone Complex
Author(s) -
Saroli Tania,
Gelehrter Sarah,
GomezFifer Carlen A,
Van Der Velde Mary E,
Bove Edward L,
Ensing Gregory J
Publication year - 2008
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2008.00685.x
Subject(s) - medicine , hypoplastic left heart syndrome , left coronary artery , cardiology , ascending aorta , artery , surgery , aorta , heart disease
There has traditionally been less concern regarding coronary anomalies with left‐sided congenital heart lesions such as hypoplastic left heart syndrome (HLHS)or Shone complex than with other lesions. However, coronary anomalies in this setting can profoundly affect surgical intervention, particularly when surgical repair involves the ascending aorta. We describe four patients with congenital left‐sided heart lesions in which left coronary artery (LCA) anomalies substantially affected intervention and outcome. In the first two cases, the coronary anomalies were not identified prospectively and resulted in surgical injury directly to the coronary or to its surrounding region. In the latter two cases, successful identification of the coronary anomaly preoperatively allowed for modification of surgical technique and/or intervention. We conclude that detailed coronary artery assessment should be part of the routine echocardiographic evaluation of congenital left‐sided heart lesions that require surgery.