Early and Late Result of Saphenous Vein Graft for Anomalous Origin of Left Coronary Artery from Pulmonary Artery

Abstract

The early and late postoperative angiographic status of the aortocoronary artery saphenous vein graft was studied in six children treated surgically for anomalous origin of left coronary artery from the pulmonary artery. Anastomosis was made to the main left coronary artery in five and to the left anterior descending coronary artery in one. At the first postoperative heart catheterization five of the six vein grafts were found to be patent without stenosis, dilatation, or wall irregularity. The second, late postoperative study performed in the five patients with initially patent grafts showed that one graft had occluded, two had stenosed at the site of the anastomosis with the coronary artery, and one had dilated distally. At the time of the second postoperative study, the treadmill exercise test was normal in three patients, slightly abnormal in the patient with graft stenosis at the site of anastomosis to the left anterior descending coronary artery, and distinctly abnormal in the patient with the occluded graft. Aortocoronary artery saphenous vein graft is a technically successful operation for anomalous origin of the left coronary artery from the pulmonary artery, but obliterative changes may occur in the vein graft in children who are apparently free from atherosclerotic coronary artery disease.