[HSF] ALCAPA - Angio

[Lalit Kapoor]

We did the procedure in three steps

1) Created an AP window
2) Fashioned the intrapulmonary tunnel connecting the created AP window with
the LCA ostium
3) Closed the Pulmonary artery with augmentation using pericardium


STEP 2

Tunnel 1 - A 6 mm PTFE graft was slit open longitudinally and sutureing 
begun at the LCA ostia

Tunnel 2 - The cranial side of the tunnel sutured to the back wall of the 
pulmonary artery

Tunnel 3 - The caudal side of the tunnel sutured similarly completing the 
tunnel from the AP window to the LCA Ostium







----- Original Message ----- 
From: "Dr. Roberto Battellini" <battr at medizin.uni-leipzig.de>
To: <OpenHeart-L at lists.hsforum.com>
Sent: Wednesday, March 19, 2008 1:44 PM
Subject: AW: [HSF] ALCAPA - Angio


Plese, send them to Prasanna, he ist he King of computers.

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Lalit Kapoor
Gesendet: Dienstag, 18. März 2008 17:53
An: OpenHeart-L at lists.hsforum.com
Betreff: Re: [HSF] ALCAPA - Angio


Roberto

I did not reimplant the LCA as it was arising from the Posterior sinus on
ithe leftward aspect making it a long distance to pull the ostium.

Instead we did a modification of the Takeuchi repair (Like Arcinegas) using
a PTFE tunnel within the PA.

I have some lovely photos of the operation and the postoperative CT angio
which I can share if I can learn how to post onto the Forum.

Lalit


----- Original Message ----- 
From: "Dr. Roberto Battellini" <battr at medizin.uni-leipzig.de>
To: <OpenHeart-L at lists.hsforum.com>
Sent: Tuesday, March 18, 2008 4:18 PM
Subject: AW: [HSF] ALCAPA - Angio


Lalit,
Very nice angio, did you perform a reimplantation?
Roberto

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Lalit Kapoor
Gesendet: Dienstag, 18. März 2008 03:30
An: OpenHeart-L
Betreff: [HSF] ALCAPA - Angio





Recently a 26 year old lady came to our Surgery clinic with a history of
chest pain on exertion for the past 3 years. She also had some palpitations
and shortness of breath.

Clinically there was a continuous murmur on the Upper Left parasternal area.

ECG showed some Anterolateral changes suggestive of ischaemia.

Here are three snapshots from her Angiogram.

Would members of this forum prefer a direct repair (2 coronary system
repair) or would instead go for ligation of the ALCAPA with a LIMA to the
LAD?

Attached photos are:

3) RCA Injection with filling of the dilated Right coronary


2) Retrograde filling of the Left Anterior descending artery

1) Retrograde filling of the Pulmonary artery


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