Objectives: The anomalous origin of the coronary artery from the pulmonary artery is a rare disease entity. We report our surgical results to restore two-coronary system for our patients.
Methods: Two male babies, 1-month-old and 2-month-old, who suffered from anomalous origin of the left coronary artery from the pulmonary artery, presented with intermittent shortness of breath and tachypnea with cyanosis respectively. The third male baby, 4-month-old, who suffered from anomalous origin of the right coronary artery from the pulmonary artery, presented with shortness of breath leading to cardiogenic shock. LV dilatation was found in all the patients. Regarding mitral regurgitation, moderate degree for the first patient, severe degree for the second, and mild-to-moderate degree for the last. The Takeuchi procedure to re-route the left coronary artery to the ascending aorta through the intra-pulmonary artery baffle was done for the first two patients. Mitral valvuloplasty was done for the second patient. Re-implantation of the right coronary artery was performed for the last patient.
Results: All the patients survived the operation and were discharged from the hospital. Peritoneal dialysis was used for the first two patients in the immediately postoperative period. During the follow up (7-83 months), all the patients regained normal LV function and have good physical activity. As for the mitral regurgitation, trivial degree for the first patient, moderate degree for the second and none for the last.
Conclusions: Restoration of two-coronary system is the surgical goal for patients with anomalous origin of the coronary artery from the pulmonary artery.