J Thorac Cardiovasc Surg 2005;130:897-899
© 2005 The American Association for Thoracic Surgery
a Department of Pediatric Cardiovascular Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
b Department of Pediatrics Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
Received for publication March 21, 2005; accepted for publication April 1, 2005. * Address for reprints: Masaaki Yamagishi, MD, PhD, Department of Pediatric Cardiovascular Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi, Hirokoji, Kamikyo-ku, Kyoto, 602-8566 Japan (Email: firstname.lastname@example.org).
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Broad ischemia of the left ventricle and subsequent severe ventricular failure are unavoidable in infants with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Here we report the first case of successful partial left ventriculectomy in a 3-month-old infant with severe ischemic cardiomyopathy caused by ALCAPA and vanishingly scarce collateral vessels.
A 3-month-old female infant weighing 5300 g with congestive heart failure was referred to our hospital. Abnormal Q waves were detected in leads I and aVL and precordial leads V4 through V6 on electrocardiography. Echocardiography demonstrated marked left ventricular (LV) dilatation with significant reduction in ventricular wall thickness (Figure 1, left). The LV end-diastolic diameter was 48 mm. Wall motion showed marked diffuse deterioration. Shortening fraction was reduced to 7%. Posterolateral wall thickness faded to 2 mm. The papillary muscles and endocardium showed markedly increased echogenicity. Severe mitral regurgitation was also observed. The left coronary artery originated
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