Guo Hong-Wei, Xu Jiang-Ping, Song Yun-Hu, Shen Xiang-Dong, Li Shou-Jun, Hu Sheng-Shou
Department of Cardiovascular Surgery, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China.
Asian Cardiovasc Thorac Ann. 2007 Jun;15(3):240-2. doi: 10.1177/021849230701500314.
Patients with anomalous origin of the left coronary artery from the pulmonary artery often have mitral valve regurgitation. Although establishing dual coronary circulation is the procedure of choice, there remains controversy as to how the mitral valve is handled. Between April 1999 and August 2005, 8 patients underwent surgical correction at our institution. There were 4 males and 4 females, aged from 9 months to 13 years (mean, 6.4 years). Six patients underwent direct aortic reimplantation and 2 had a Takeuchi procedure. Simultaneous mitral annuloplasty was performed in 7 patients with moderate or severe mitral regurgitation. There were no deaths or postoperative complications. Follow-up ranged from 4 to 80 months (mean, 34 +/- 26 months). Left ventricular function improved significantly from a preoperative fractional shortening of 0.21 +/- 0.09 to 0.35 +/- 0.06. Mitral regurgitation decreased on follow-up in the 7 patients who had mitral annuloplasty. We recommend performing mitral annuloplasty at the time of operation in patients with moderate or severe mitral regurgitation and anomalous origin of the left coronary artery from the pulmonary artery.
左冠状动脉起源于肺动脉的患者常伴有二尖瓣反流。尽管建立双冠状动脉循环是首选的手术方法，但对于如何处理二尖瓣仍存在争议。1999年4月至2005年8月，我院有8例患者接受了手术矫正。其中男性4例，女性4例，年龄从9个月至13岁（平均6.4岁）。6例患者接受了直接主动脉再植术，2例接受了竹内手术。7例中重度二尖瓣反流患者同时进行了二尖瓣环成形术。无死亡病例及术后并发症。随访时间为4至80个月（平均34±26个月）。左心室功能显著改善，术前缩短分数为0.21±0.09，术后为0.35±0.06。7例行二尖瓣环成形术的患者随访时二尖瓣反流减轻。我们建议，对于中重度二尖瓣反流且左冠状动脉起源于肺动脉的患者，在手术时应进行二尖瓣环成形术。
