BACKGROUND: This study investigates the correlation between surgical timing and 15-year longitudinal left ventricular and mitral valve function, after repair of @entity3466 coronary artery origin from the pulmonary artery. METHODS: Between 1987 and 2002, 31 @entity1 (median age, 7.1 months) underwent repair for @entity3466 origin of the left (n = 28), right (n = 2), or both (n = 1) coronary arteries from the pulmonary artery. Repair was accomplished by subclavian interposition in 5 @entity1 , intrapulmonary tunnel in 12, and direct aortic reimplantation in 14. Primary mitral valve repair was never associated with coronary revascularization. Total follow-up was 186.4 @entity1 -years (mean, 77.2 months). RESULTS: Fifteen-year actuarial survival was 92.9% +/- 4.9% for coronary transfer, 40.0% +/- 21.9% for subclavian interposition, and 89.9% +/- 7.5% for intrapulmonary tunnel (p = 0.019). Five @entity1 required further intervention for @entity849 (n = 3), baffle leak (n = 1), and mitral valve replacement (n = 1). Coronary transfer allowed best freedom from long-term reoperation (92.3% +/- 7.4%). Left ventricular shortening fraction increased from 17.3% +/- 6.3% before operation to 34.1% +/- 4.6% at last follow-up (p < 0.01). Regression analysis demonstrated a linear relationship between age at repair and shortening fraction recovery (r(2) = 0.573, p < 0.01). @entity1 younger than 6 months of age showed worse preoperative shortening fraction (15.9% +/- 5.2%) and best longitudinal shortening fraction recovery (36.4% +/- 5.1%; p < 0.001). Major improvement in mitral valve function was observed within 1 year from surgery in 90.4% of survivors. CONCLUSIONS: Repair of @entity3466 coronary artery origin from the pulmonary artery in younger symptomatic @entity1 offers the best potential for recovery of left ventricular function, despite a worse initial presentation. Coronary transfer is associated with superior long-term survival and freedom from reoperation. Most @entity1 with patent two-coronary repair will recover normal mitral valve function; therefore, simultaneous mitral valve surgery seems unwarranted.

XXXX coronary artery origin from the pulmonary artery: correlation between surgical timing and left ventricular function recovery.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'infants'] @entity849 :: ('MESH:D011666', 'Disease') :: ['supravalvular pulmonary stenosis'] @entity3466 :: ('MESH:D003784', 'Disease') :: ['anomalous']
@entity3466 :: (MESH:D003784,Disease) :: ['Anomalous']
