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Anomalous left coronary artery from pulmonary artery repair: Outcomes from the European Congenital Heart Surgeons Association Database
Author(s) -
Triglia Laura Torlai,
Guariento Alvise,
Zanotto Lorenza,
Zanotto Lucia,
Cattapan Claudia,
Hu Renjie,
Zhang Haibo,
Herbst Claudia,
Hörer Jurgen,
Sarris George,
Ebels Tjark,
Maruszewski Bohdan,
Tobota Zdzislaw,
Blitzer David,
Lorenzoni Giulia,
Bottigliengo Daniele,
Gregori Dario,
Padalino Massimo,
Di Salvo Giovanni,
Vida Vladimiro L.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15448
Subject(s) - medicine , concomitant , cardiopulmonary bypass , pulmonary artery , mitral valve replacement , cardiology , mitral valve , artery , aortic cross clamp , aortic valve replacement , surgery , cardiac surgery , circulatory system , pulmonary hypertension , mitral valve repair , stenosis
We sought to determine the surgical outcomes of patients with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) enrolled in the European Congenital Heart Surgeons Association (ECHSA) database. Materials and Methods From 1999 to 2019, 907 patients with ALCAPA underwent surgical repair and were included in the current study. The primary outcome was in‐hospital mortality. Secondary outcomes included frequency and results of concomitant mitral valve surgery and postoperative mechanical circulatory support (MCS). Results The overall in‐hospital mortality was 6% (54/907) and was significantly higher in neonates ( p = .01), patients with lower body surface area (BSA) ( p = .01), and those requiring postoperative MCS ( p = .001). Associated mitral valve surgery was performed in 144 patients (15.9%) and was associated with longer cardiopulmonary bypass (CPB) and aortic cross‐clamp times (AOX) ( p ≤ .0001) but was not significantly related to an increase in in‐hospital mortality. Postoperative MCS was required in 66 patients (7.3%). These patients were younger ( p ≤ .001), had a lower BSA ( p ≤ .001), and required a longer CPB ( p ≤ .001) and AOX time ( p ≤ .001). Conclusions ALCAPA repair can be achieved successfully, and with low surgical risk. Concomitant mitral valve procedures can be performed without increasing operative mortality. The use of MCS remains a valuable option, especially in younger patients.