Objective:Coronary artery translocation is a critical stage of arterial switch procedure and surgery of ALCAPA. In some coronary abnormalities direct translocation can be impossible and different surgical techniques has been described to solve this problem.We used total autogenous composit tunnel to faciliate coronary transfer in 7 patients.
Material:This technique consist of elongation of coronary button by creating a tube using part of the wall of pulmonary artery and aorta. Three of the patients have ALCAPA with left coronary artery arising remotely from aorta, other 4 patients were TGA with unusual coronary patterns. Age of the patients ranged between 5 days to 12 years.
Results: All patients had uneventful postoperative course. All patients were followed with echocardiography and ECG. Mean follow up time was 2.6± 1.5 years. All patients are alive and had NYHA class1 functional status. Nonewly deleopped ischemic finding were presented after surgery until present. Three patient had control angiograhy which demonstrated widely open tunnel and patent coronary circlation.
Conclsion: Total autogenous composit tunnel can be performed succesfully to faciliate coroanary tranfer in some cases. Althought we had limited experience we believe that this technique is a good surgical alternative. We suggest that in situ utilization of autogeneous tissues had advantages of preventing trombosis and restenosis and had growth potentiel.