Coronary ostioplasty for congenital atresia of the left main coronary artery ostium

David J. Kaczorowski, Shyam Sathanandam, Chitra Ravishankar, Matthew J. Gillespie, Lisa M. Montenegro, Peter J. Gruber, Thomas L. Spray, J. William Gaynor, Kimberly Y. Lin

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Coronary ostial atresia is a rare anomaly, most frequently managed with coronary artery bypass grafting. This condition is often misdiagnosed as anomalous left coronary artery from the pulmonary artery until the time of surgical intervention, leaving the surgeon little time to contemplate the best operative technique. Methods: In this single-center experience, three cases of congenital atresia of the left main coronary artery presenting during childhood were surgically managed with homograft patch ostioplasty. Results: Antegrade left coronary artery blood flow was successfully established in all three cases without the use of a bypass graft. Two children survived and are clinically well; the third had visibly necrotic myocardium at the time of surgical ostioplasty and did not survive to hospital discharge. Conclusions: Surgical ostioplasty with a homograft patch should be considered as an alternative to bypass grafting for coronary ostial atresia in children.

Original languageEnglish (US)
Pages (from-to)1307-1310
Number of pages4
JournalAnnals of Thoracic Surgery
Volume94
Issue number4
DOIs
StatePublished - Oct 1 2012

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Coronary Vessels
Allografts
Diagnostic Errors
Coronary Artery Bypass
Pulmonary Artery
Myocardium
Transplants
Surgeons

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kaczorowski, D. J., Sathanandam, S., Ravishankar, C., Gillespie, M. J., Montenegro, L. M., Gruber, P. J., ... Lin, K. Y. (2012). Coronary ostioplasty for congenital atresia of the left main coronary artery ostium. Annals of Thoracic Surgery, 94(4), 1307-1310. https://doi.org/10.1016/j.athoracsur.2012.04.072

Coronary ostioplasty for congenital atresia of the left main coronary artery ostium. / Kaczorowski, David J.; Sathanandam, Shyam; Ravishankar, Chitra; Gillespie, Matthew J.; Montenegro, Lisa M.; Gruber, Peter J.; Spray, Thomas L.; Gaynor, J. William; Lin, Kimberly Y.

In: Annals of Thoracic Surgery, Vol. 94, No. 4, 01.10.2012, p. 1307-1310.

Research output: Contribution to journalArticle

Kaczorowski, DJ, Sathanandam, S, Ravishankar, C, Gillespie, MJ, Montenegro, LM, Gruber, PJ, Spray, TL, Gaynor, JW & Lin, KY 2012, 'Coronary ostioplasty for congenital atresia of the left main coronary artery ostium', Annals of Thoracic Surgery, vol. 94, no. 4, pp. 1307-1310. https://doi.org/10.1016/j.athoracsur.2012.04.072
Kaczorowski, David J. ; Sathanandam, Shyam ; Ravishankar, Chitra ; Gillespie, Matthew J. ; Montenegro, Lisa M. ; Gruber, Peter J. ; Spray, Thomas L. ; Gaynor, J. William ; Lin, Kimberly Y. / Coronary ostioplasty for congenital atresia of the left main coronary artery ostium. In: Annals of Thoracic Surgery. 2012 ; Vol. 94, No. 4. pp. 1307-1310.
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AB - Background: Coronary ostial atresia is a rare anomaly, most frequently managed with coronary artery bypass grafting. This condition is often misdiagnosed as anomalous left coronary artery from the pulmonary artery until the time of surgical intervention, leaving the surgeon little time to contemplate the best operative technique. Methods: In this single-center experience, three cases of congenital atresia of the left main coronary artery presenting during childhood were surgically managed with homograft patch ostioplasty. Results: Antegrade left coronary artery blood flow was successfully established in all three cases without the use of a bypass graft. Two children survived and are clinically well; the third had visibly necrotic myocardium at the time of surgical ostioplasty and did not survive to hospital discharge. Conclusions: Surgical ostioplasty with a homograft patch should be considered as an alternative to bypass grafting for coronary ostial atresia in children.

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