AufderHeide J F, Gutierrez F R, Hartmann A F, Weldon C S, Biello D R
Pediatr Cardiol. 1982;3(3):229-35. doi: 10.1007/BF02240457.
Considerable controversy surrounds the optimal management of symptomatic infants with anomalous origin of the left coronary artery from the pulmonary artery; this includes the timing and type of surgical intervention. Long-term follow-up was obtained on three patients who had simple ligation of the anomalous left coronary artery at or before 8 months of age; long-term follow-up on an adolescent treated with a saphenous vein bypass graft from the aorta to the coronary artery was available for comparison. Remarkable increase in left ventricular contractility was observed in the three patients treated only by simple ligation of the anomalous left coronary artery during infancy. Thallous chloride T1 201 exercise studies disclosed no perfusion abnormalities in any of the patients despite angiographically demonstrable wall-motion abnormalities in two of the four patients. Our study suggests that simple ligation of the anomalous left coronary artery near its origin in patients with angiographically detectable left-to-right shunting can provide long-term survival with good left ventricular function and minimal clinical complaints.
对于症状性左冠状动脉起源于肺动脉的婴儿，其最佳治疗方法存在相当大的争议，这包括手术干预的时机和类型。我们对3例在8个月及以前单纯结扎异常左冠状动脉的患者进行了长期随访，并与1例接受从主动脉到冠状动脉的大隐静脉搭桥术治疗的青少年患者的长期随访结果进行了比较。仅在婴儿期对异常左冠状动脉进行单纯结扎治疗的3例患者，左心室收缩力显著增加。尽管4例患者中有2例血管造影显示有室壁运动异常，但氯化铊T1 201运动研究显示，所有患者均无灌注异常。我们的研究表明，对于血管造影可检测到左向右分流的患者，在异常左冠状动脉起源附近进行单纯结扎，可使患者长期存活，左心室功能良好，临床症状轻微。
