ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Anomalous origin of coronary arteries from the pulmonary artery: A single-center experience
Fadli Demir1, Tolga Akbaş1, Sevcan Erdem1, Berivan Subaşı1, Celal Varan1, Orhan Kemal Salih2, Nazan Özbarlas1
1Department of Pediatrics, Division of Pediatric Cardiology, Çukurova University Faculty of Medicine, Adana, Türkiye
2Department of Cardiovascular Surgery, Division of Pediatric Cardiac Surgery, Çukurova University Faculty of Medicine, Adana, Türkiye
DOI : 10.5606/tgkdc.dergisi.2023.23396
Background: The aim of the study was to evaluate the clinical and diagnostic findings, treatment, and follow-up of cases of anomalous origin of coronary arteries from the pulmonary artery.

Methods: Between January 1998 and June 2021, a total of 14 patients (5 males, 9 females; median age: 15 months; range, 3 to 156 months) diagnosed with anomalous origin of coronary arteries from the pulmonary artery were retrospectively analyzed. Demographic and clinical data of the patients, electrocardiographic, echocardiographic, angiographic, surgical, and follow-up findings were evaluated.

Results: The most common symptoms were respiratory distress (n=6) and murmur (n=3). With the exception of three cases, all other patients were diagnosed by echocardiography in the first examination. Severe mitral valve insufficiency was detected in four patients and four other patients had moderate mitral insufficiency on echocardiography. Ejection fraction values ranged between 38 and 79%. Eleven patients underwent direct implantation of the coronary artery into the aorta, and three underwent a Takeuchi procedure. Mortality occurred in only one case. After surgery, mitral insufficiency and ejection fraction values improved. Median follow-up was 62 (range, 5 to 170) months and all patients were asymptomatic, except one who required redo surgery.

Conclusion: Anomalous origin of the coronary arteries from the pulmonary artery is an uncommon congenital anomaly. Echocardiography is the main diagnostic tool. If all echocardiographic findings of the coronary anomaly are not investigated thoroughly, the diagnosis may be overlooked.

Keywords : Anomalous origin of the coronary arteries from the pulmonary artery, congenital coronary abnormality, echocardiography, surgery
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