Abstract
Objective. To evaluate the long-term results of correction of abnormal divergence of one of the coronary arteries from the pulmonary artery system by means of its reimplantation or by tunneling.
Material and methods. From November 2010 to January 2022, 18 patients with various variants of coronary artery origin from the pulmonary artery system were operated at the Federal Center for Cardiovascular Surgery (Penza). The majority of patients (n=15, 83%) underwent coronary artery reimplantation into the aorta, 3 (17%) patients underwent Takeuchi operation (creation of an intrapulmonary coronary artery tunnel).
Results. Good immediate and long-term results of interventions were achieved: ischemic dysfunction of the left ventricle was eliminated with the restoration of its geometry and contractile ability, the initial mitral insufficiency regressed (repeated reconstructive intervention for persistent pronounced mitral insufficiency was required only for one patient after Takeuchi operation). Only one patient died in the early postoperative period after Takeuchi operation. The rest of the patients, even initially in extremely serious condition, have recovered, have no complaints about their health in the long-term, are in the I functional class of chronic heart failure and do not require drug therapy.
Conclusion. The best immediate and long-term results were achieved after reimplantation of an anomalous coronary artery into the aorta. If direct translocation of the coronary artery is not possible due to anatomical limitations, the Takeuchi procedure can be used.
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About the authors
- Igor’ E. Chernogrivov, Dr. Med. Sci., Cardiovascular Surgeon; ORCID
- Aleksey A. Shikhranov, Cand. Med. Sci., Cardiovascular Surgeon, Head of Cardiac Surgery Department No. 4; ORCID
- Ekaterina V. Vostokova, Pediatric Cardiologist; ORCID
- Anastasiya O. Ryabova, Pediatric Cardiologist; ORCID
- Lyudmila N. Lashmanova, Pediatric Cardiologist; ORCID
- Irina S. Nazarova, Pediatric Cardiologist; ORCID
- Tat’yana V. Rybakova, Pediatric Cardiologist; ORCID
- Vladlen V. Bazylev, Dr. Med. Sci., Professor, Cardiovascular Surgeon, Chief Physician; ORCID
