Reconstruction of coronary artery anomaly in an infant using the internal mammary artery: 10-year follow-up
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We report a case of tetralogy of Fallot with an unsuspected anomalous left anterior descending coronary artery arising from the right coronary artery and crossing the right ventricular outflow tract in a 16-month-old infant. During operation, the anomalous artery was severed. Successful repair of the intracardiac anomalies was performed, including left anterior descending-internal mammary artery reconstruction of the anomalous artery. This case illustrates the importance of delineation of coronary artery anatomy and even selective coronary arteriography in patients with tetralogy of Fallot, since anomalous coronary arteries occur most frequently in association with other cardiac anomalies. Arteriography 10 years later revealed a patent anastomosis to the left anterior descending artery, proving the durability of the internal mammary artery in a patient we believe to be the youngest to have undergone bypass with this particular conduit.
Key wordsAnomalous coronary artery Tetralogy of Fallot Internal mammary artery
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- 1.Abbott ME (1906) Anomalies of the coronary arteries. In: McCrae T (ed)Osler's modern medicine. Lea and Febiger, Philadelphia, p 420Google Scholar
- 2.Arciniegas E (1985)Pediatric cardiac surgery. Chicago, Year Book Medical Publishers, pp 389–402Google Scholar
- 4.Cameron A, Davis K, Green GE, Myers WO, Pettinger M (1986) Internal mammary artery bypass: a multicenter experience. Clinical presentation, American Heart Association 59th Scientific Sessions, Dallas, NovemberGoogle Scholar
- 6.Cooley DA (1984) Repair of coronary artery anomalies. In:Techniques in cardiac surgery, 2nd edn. WB Saunders, Philadelphia, pp 259–272Google Scholar
- 8.Culham JAG (1978) Congenital anomalies of the coronary arteries. In: Keith JD, Rowe RD, Vlad P (eds)Heart disease in infancy and childhood. Macmillan, New York, chap 47Google Scholar
- 9.el-Said GM, Ruzyllo W, Williams RL, Mullins CE, Hallman GL, Cooley DA, McNamara DG (1973) Early and late result of saphenous vein graft for anomalous origin of left coronary artery from the pulmonary artery.Circulation [Suppl3]48:2–6Google Scholar
- 15.Meyer J, Reul GJ, Chiariello L, Hallman GL, Cooley DA (1975) Anomalous origin and distribution of coronary arteries: review of 38 patients who underwent operation.J Thorac Cardiovasc Surg 16:500–505Google Scholar