Maldonado-Cañón Kevin, Motta Andrés Felipe, Prada Silvia Alejandra, Maldonado-Escalante Javier
Grupo de investigación en Cirugía Cardiovascular, Department of Surgery, Clínica Universitaria Colombia, Bogotá, Colombia.
Cardiovascular Surgery Section, Department of Surgery, Clínica Universitaria Colombia, Bogota, Colombia.
Interdiscip Cardiovasc Thorac Surg. 2024 Aug 1;39(2). doi: 10.1093/icvts/ivae142.
Despite promising results, reimplantation appears to have fallen into oblivion among the multiple possible approaches for repairing anomalous coronary arteries. We describe the outcomes of 12 patients with an anomalous right coronary artery originating from the opposite sinus of Valsalva with an interarterial course who were surgically treated with this technique between 2018 and 2023 in 2 institutions in Bogota, Colombia. We provide preliminary evidence of the value reimplantation as a more than suitable technique, particularly in resource-constrained settings. It offers high rates of control of symptoms and functional class recovery while assessing all potential high-risk features, with a low risk of complications, even in middle-aged patients. We also advocate using noninvasive anatomical descriptions and patient symptoms over inducible ischaemia tests in decision making.
尽管取得了令人鼓舞的结果，但在修复异常冠状动脉的多种可能方法中，再植术似乎已被遗忘。我们描述了12例右冠状动脉起源于对侧瓦尔萨尔瓦窦且走行于动脉间的患者的手术结果，这些患者于2018年至2023年期间在哥伦比亚波哥大的2家机构接受了该技术的手术治疗。我们提供了初步证据，证明再植术是一种非常合适的技术，特别是在资源有限的情况下。它在评估所有潜在的高风险特征时，能实现高比例的症状控制和功能分级恢复，并发症风险低，即使是中年患者也是如此。我们还提倡在决策过程中使用非侵入性解剖描述和患者症状，而不是诱发缺血试验。
