[HSF] anomalus origen left coronary

[Michael Firstenberg]

I would fix it - there are a variety of techniques which can be used
depending on where on the PA it comes off of.  However, the methods used in
children might not work for adults (i.e. reimplantation) - but a tunnel may
work.  We have seen several of these recently, and bypass may the be easiest
way (i.e. LIMA-LAD, something to a circ) and close the hole in a 68
year/old.  Logic would suggest antegrate through the PA (but I have not
heard that described before) and clearly I would use retrograde.  How do the
rest of her coronaries look?

But that would be my "youngster" approach to this.  But you must fix it.  I
am sure others with have more direct experience with this problem in adults
- but remember adults are not big children.

Let us know what you do

-michael


On 3/17/08, edgar manrique <edman63 at hotmail.com> wrote:
>
>
>
> we have a 68 yo female with double lesion mitral and aortic valve
> regurgitation and trycuspidea regurgitation and auricular fibrilation, and
> EF 55 % of LV, and she has a origen of left coronary artery from pulmonar
> artery trunck, and she hasnt been with myocardila isquemia, our question is
> : 1. there is surgical indication 2. if is yes so, is necessary for LCA clip
> or graft with safenus or mamary artery, and how is the myocardial protection
> in pump ??
> thanks
> edgar j manrique
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