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The Journal of Thoracic and Cardiovascular Surgery, Vol 100, 270-273, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Postoperative evaluation after end-to-end subclavian-left coronary artery anastomosis in anomalous left coronary artery

M Montigny, P Stanley, C Chartrand, E Selman, A Fournier and A Davignon
Department of Cardiology, Sainte-Justine Hospital, University of Montreal, Quebec, Canada.

In most instances of anomalous left coronary artery originating from the pulmonary artery, surgical treatment is recommended. Because establishment of a direct systemic to coronary blood flow is expected to provide the best recovery of left ventricular function, various corrective procedures have been proposed. Subclavian-left coronary artery anastomosis appears to be a logical approach. Four patients operated on at Sainte-Justine Hospital, at an average age of 33 months (27 to 44), with an end-to-end subclavian-left coronary artery anastomosis were evaluated 6 to 46 months postoperatively. The anastomosis was patent in all cases. End-diastolic volume index (74.6 +/- 24.7 versus 122.7 +/- 15.3 ml/m2) and ejection fraction (0.58 +/- 0.07 versus 0.33 +/- 0.06) were improved significantly. Subclavian-left coronary artery anastomosis appears to meet the main criteria for an optimal physiologic correction of anomalous left coronary artery: restoration of a two-coronary artery system, improvement of left ventricular function, and likelihood of long-term patency.

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