Akkaya Gökmen, Bilen Çağatay, Tuncer Osman Nuri, Ayık Mehmet Fatih, Atay Yüksel
Ege University School of Medicine Department of Cardiovascular Surgery Izmir Turkey Department of Cardiovascular Surgery,Ege University School of Medicine, Izmir, Turkey.
Braz J Cardiovasc Surg. 2019 Dec 1;34(6):687-693. doi: 10.21470/1678-9741-2018-0376.
This study aimed to evaluate the early operative outcomes and to compare the left ventricle and mitral valve functions after initial Takeuchi repair in patients with anomalous left coronary arising from pulmonary artery (ALCAPA).
Fourteen patients (5 males, 9 females; mean age 4.3 years, ranging from 25 days to 34 years) who were operated for ALCAPA between 2007 and 2018 were included in this study. Data were evaluated retrospectively based on our medical records.
Hospital mortality rate was 7.1% (n=1). Thirteen surviving patients were kept in follow-up mean 4.3±3.05 years. When compared to preoperative measurements, both left ventricular ejection fraction (LVEF), (P=0.007) and mitral regurgitation (MR) (P=0.001) significantly improved before discharge. Moreover, LVEF values were improved in the late follow-up, considering early postoperative outcomes, and this alteration was significant (P=0.014). Nevertheless, alteration in the degree of MR among patients did not differ in the long-term follow-up (P=0.180). There was no late-term mortality or need for reoperation among patients.
Although some centers prefer to direct implantation in ALCAPA, Takeuchi procedure can be accepted as a reliable method that provides satisfactory long-term results, considering that it aids to improve left ventricle ejection fraction and reduced mitral valve regurgitation.
本研究旨在评估肺动脉起源异常左冠状动脉（ALCAPA）患者初次竹内修复术后的早期手术效果，并比较左心室和二尖瓣功能。
本研究纳入了2007年至2018年间因ALCAPA接受手术的14例患者（5例男性，9例女性；平均年龄4.3岁，范围为25天至34岁）。基于我们的病历对数据进行回顾性评估。
医院死亡率为7.1%（n = 1）。13例存活患者平均随访4.3±3.05年。与术前测量值相比，出院前左心室射血分数（LVEF）（P = 0.007）和二尖瓣反流（MR）（P = 0.001）均显著改善。此外，考虑术后早期结果，晚期随访时LVEF值有所改善，且这种变化具有显著性（P = 0.014）。然而，患者中MR程度的变化在长期随访中无差异（P = 0.180）。患者中无晚期死亡或再次手术的需要。
尽管一些中心更倾向于在ALCAPA中直接植入，但考虑到竹内手术有助于提高左心室射血分数并减少二尖瓣反流，可将其视为一种能提供满意长期结果的可靠方法。
