Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve
ObjectiveUse of concomitant mitral valve repair remains controversial in the anomalous left coronary artery from the pulmonary artery (ALCAPA) with mitral regurgitation (MR). This study aimed to evaluate postoperative mitral valve function and explore the indication for concomitant mitral valve repa...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-10-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.953420/full |
| _version_ | 1798028192742637568 |
|---|---|
| author | Juemin Yu Juemin Yu Qiushi Ren Qiushi Ren Xiaobing Liu Tianyu Chen Rong Liufu Shusheng Wen Jimei Chen Jianzheng Cen Jian Zhuang |
| author_facet | Juemin Yu Juemin Yu Qiushi Ren Qiushi Ren Xiaobing Liu Tianyu Chen Rong Liufu Shusheng Wen Jimei Chen Jianzheng Cen Jian Zhuang |
| author_sort | Juemin Yu |
| collection | DOAJ |
| description | ObjectiveUse of concomitant mitral valve repair remains controversial in the anomalous left coronary artery from the pulmonary artery (ALCAPA) with mitral regurgitation (MR). This study aimed to evaluate postoperative mitral valve function and explore the indication for concomitant mitral valve repair.Materials and methodsThe medical records of 111 patients with ALCAPA and MR who underwent ALCAPA surgery between April 2006 and November 2020 were reviewed. The patients were categorized into three groups for comparison, namely, group I consisted of 38 patients with trivial or mild MR who underwent ALCAPA repair only; group II consisted of 37 patients with moderate or severe MR who similarly had only surgery of the ALCAPA performed; and group III consisted of 36 patients who had concomitant mitral valve repair for moderate or severe MR.ResultOverall mortality was 7.2% (8 of 111). The mortality of group II (16.2%, 6 of 37) was higher than those of groups I (5.3%, 2 of 38) and III (0%, 0 of 36) (p = 0.027). All three patients who underwent mitral valve reintervention were in group II. At the last follow-up, none of the patients had more than moderate MR in group I. The percentage of patients with improved MR grade was 79.4% (27 of 34) in group III and 51.4% (19 of 37) in group II (p = 0.001). The multivariate logistic regression revealed that concomitant mitral valve repair (adjusted odds ratio = 4.492, 95% CI: 1.909–12.794; p < 0.001) was the major factor influencing MR grade improvement.ConclusionThe long-term outcomes after ALCAPA repair were favorable. For mild MR, ALCAPA repair only can be performed. For moderate and severe MR, we suggest concomitant mitral valve repair. |
| first_indexed | 2024-04-11T19:03:49Z |
| format | Article |
| id | doaj.art-3831fa1f17264b0198454bd9d6093393 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T19:03:49Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-3831fa1f17264b0198454bd9d60933932022-12-22T04:07:50ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-10-01910.3389/fcvm.2022.953420953420Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valveJuemin Yu0Juemin Yu1Qiushi Ren2Qiushi Ren3Xiaobing Liu4Tianyu Chen5Rong Liufu6Shusheng Wen7Jimei Chen8Jianzheng Cen9Jian Zhuang10Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaSchool of Medicine, South China University of Technology, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaSchool of Medicine, South China University of Technology, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaObjectiveUse of concomitant mitral valve repair remains controversial in the anomalous left coronary artery from the pulmonary artery (ALCAPA) with mitral regurgitation (MR). This study aimed to evaluate postoperative mitral valve function and explore the indication for concomitant mitral valve repair.Materials and methodsThe medical records of 111 patients with ALCAPA and MR who underwent ALCAPA surgery between April 2006 and November 2020 were reviewed. The patients were categorized into three groups for comparison, namely, group I consisted of 38 patients with trivial or mild MR who underwent ALCAPA repair only; group II consisted of 37 patients with moderate or severe MR who similarly had only surgery of the ALCAPA performed; and group III consisted of 36 patients who had concomitant mitral valve repair for moderate or severe MR.ResultOverall mortality was 7.2% (8 of 111). The mortality of group II (16.2%, 6 of 37) was higher than those of groups I (5.3%, 2 of 38) and III (0%, 0 of 36) (p = 0.027). All three patients who underwent mitral valve reintervention were in group II. At the last follow-up, none of the patients had more than moderate MR in group I. The percentage of patients with improved MR grade was 79.4% (27 of 34) in group III and 51.4% (19 of 37) in group II (p = 0.001). The multivariate logistic regression revealed that concomitant mitral valve repair (adjusted odds ratio = 4.492, 95% CI: 1.909–12.794; p < 0.001) was the major factor influencing MR grade improvement.ConclusionThe long-term outcomes after ALCAPA repair were favorable. For mild MR, ALCAPA repair only can be performed. For moderate and severe MR, we suggest concomitant mitral valve repair.https://www.frontiersin.org/articles/10.3389/fcvm.2022.953420/fullcongenital heart diseaseanomalous left coronary artery from the pulmonary artery (ALCAPA)mitral regurgitationconcomitant mitral valve repairoutcome |
| spellingShingle | Juemin Yu Juemin Yu Qiushi Ren Qiushi Ren Xiaobing Liu Tianyu Chen Rong Liufu Shusheng Wen Jimei Chen Jianzheng Cen Jian Zhuang Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve Frontiers in Cardiovascular Medicine congenital heart disease anomalous left coronary artery from the pulmonary artery (ALCAPA) mitral regurgitation concomitant mitral valve repair outcome |
| title | Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve |
| title_full | Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve |
| title_fullStr | Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve |
| title_full_unstemmed | Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve |
| title_short | Anomalous left coronary artery from the pulmonary artery: Outcomes and management of mitral valve |
| title_sort | anomalous left coronary artery from the pulmonary artery outcomes and management of mitral valve |
| topic | congenital heart disease anomalous left coronary artery from the pulmonary artery (ALCAPA) mitral regurgitation concomitant mitral valve repair outcome |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.953420/full |
| work_keys_str_mv | AT jueminyu anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT jueminyu anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT qiushiren anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT qiushiren anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT xiaobingliu anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT tianyuchen anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT rongliufu anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT shushengwen anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT jimeichen anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT jianzhengcen anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve AT jianzhuang anomalousleftcoronaryarteryfromthepulmonaryarteryoutcomesandmanagementofmitralvalve |