[HSF] anomalus origen left coronary

[Lalit Kapoor]

In our patient, at Operation, the RCA was similarly dilated...

We did not ligate the LCA but instead went in for a Takeuchi type repair 
creating a two coronary system

Cardioplegia was delivered antegrade - but we additionally cross clamped the 
pulmonary artery to prevent "steal" of the Cardioplegia via the LCA opening 
into a low pressure Pulmonary artery.

Once the heart had arrested we gave additional cardioplegia via the LCA 
ostium after opening the pulmonary artery.

For the second dose of cardioplegia we gave  50% via the aortic root while 
occluding the LCA ostium with finger pressure. The remaining 50% of the 
plegia was administered via the LCA ostium using a large Balloon tipped 
ostial cannula




Lalit Kapoor
Cardiac Surgeon
Apollo Hospital, Ranchi

----- Original Message ----- 
From: "edgar manrique" <edman63 at hotmail.com>
To: <openheart-l at lists.hsforum.com>
Sent: Wednesday, March 19, 2008 9:29 AM
Subject: [HSF] anomalus origen left coronary



The surgery has long 6 hours with time pump of 158 min and our surgeon did 
mitral valve repair (alfieri), trycuspide vlave repair, aortic valve 
replacement (biologic), and thorugh pulmonary artery closed the ostium of 
Left coronary artery, and he think in mammary artery graft but he said dont 
necessary. We saw another ostium in aorta artery and in this moment the 
patient is good with 55% EF, without problems until now. We had many 
problems with cardioplegia because so much coronary flow (see attach 
photos), so was good with continous CP retrograde.We are so thanks with all 
forum for your help and your opinons thank very muchedgar j manrique
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