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Myocardial Perfusion, Scarring, and Function in Anomalous Left Coronary Artery From the Pulmonary Artery Syndrome: A Long-Term Analysis Using Magnetic Resonance Imaging.
MedLine Citation:
PMID:  25130077     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect. We aimed to examine the role of cardiac magnetic resonance imaging (MRI) in the long-term surveillance of repaired ALCAPA with regard to myocardial scarring, wall motion abnormalities, perfusion deficits, and myocardial function.
METHODS: Twenty-one patients after direct reimplantation of ALCAPA (median age at operation, 2.8 years) were examined after a median 10.6 years by MRI at rest and under dobutamine stress conditions, echocardiography, and ergometry. Results were compared with preoperative, immediately postoperative (5 days), and intermediate-term (5.8 years) echocardiography.
RESULTS: No early or late deaths occurred. Improvements in indexed left ventricular end-diastolic dimension, ejection fraction, and mitral valve function were observed in all patients. However, MRI at rest showed wall motion abnormalities in 67% and perfusion deficits in 28%. Myocardial scars were seen in 67%. Dobutamine stress MRI detected wall motion abnormalities in 19% and perfusion deficits in 14%, which were not seen on MRI at rest. Exercise testing did not reflect cardiac dysfunction.
CONCLUSIONS: Although long-term follow-up showed global left ventricular function had improved after ALCAPA repair, MRI showed left ventricular wall motion abnormalities, perfusion deficits, and myocardial scarring were seen in many patients. Dobutamine stress MRI identified deficits that were not evident on MRI at rest, and can therefore be considered a valuable surveillance tool. These results suggest the need for lifelong surveillance of repaired ALCAPA.
Authors:
Boris Schmitt; Sina Bauer; Shelby Kutty; Sarah Nordmeyer; Boris Nasseri; Felix Berger; Vladimir Alexi-Meskishvili
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-14
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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