Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-07-06T07:25:38.007Z Has data issue: false hasContentIssue false
  • English
  • Français

A most peculiar coronary circulation in a patient with pulmonary atresia and intact ventricular septum

Published online by Cambridge University Press:  19 August 2008

Robert M. Freedom ,
Shi-Joon Yoo  and
Alexander Javois
Robert M. Freedom*
Affiliation:
Division of Cardiology, Department of Pediatrics, Department of Medical Imaging, the University of Toronto, Faculty of Medicine, Toronto, Canada;
Shi-Joon Yoo
Affiliation:
Division of Cardiology and Department of Pediatrics, the Hospital for Sick Children, Toronto, Canada
Alexander Javois
Affiliation:
The Heart Institute for Children, Hope Children's Hospital, Oak Lawn, Ill., USA
*
Robert M. Freedom, MD, The Hospital for Sick Children, 555 University Avenue, Room 1503C, Toronto, Canada M5G 1X8; Tel: 416–8136132; Fax: 416–8137547
Get access Rights & Permissions [Opens in a new window]

Abstract

A patient with pulmonary atresia and intact ventricular septum was found to have a right ventricular-dependent coronary circulation. In this infant both coronary arteries lacked their normal proximal connection with the aorta, perhaps the most egregious form of this prejudicial coronary circulation. Even more interesting was a direct collateral vessel originating from the descending thoracic aorta and connecting with the coronary circulation. This patient has undergone bilateral modified Blalock-Taussig shunts, and left ventricular function seems preserved.

Keywords

pulmonary atresia and intact ventricular septumcollateral coronary artery circulationabsent aorto-coronary artery proximal connectionsright ventricular-dependent coronary circulationFontan operation
Type
Brief Reports
Information
Cardiology in the Young , Volume 10 , Issue 1 , January 2000 , pp. 60 - 63
Copyright
Copyright © Cambridge University Press 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Freedom, RN, Benson, LN, Trusler, GA. Pulmonary atresia and intact ventricular septum: a consideration of the coronary circulation and ventriculo-coronary connections. Annual of Cardiac Surgery, 1989, 38–44.Google Scholar
2.Gittenberger-De Groot, AC, Sauer, U, Bindl, L, Babic, R, Essed, CE, Buhlmeyer, K. Competition of coronary arteries and ventriculo coronary arterial communications in pulmonary atresia with intact ventricular septum. Int J Cardiol 1988; 18: 243–258.CrossRefGoogle ScholarPubMed
3.Freedom, RM, Mawson, J, Yoo, S-J, Benson, LN. Congenital Heart Disease: Textbook of Angiocardiography. Futura Publishing Co. Armonk, NY 1997, 617–662Google Scholar
4.Freedom, RM. How can something so small cause so much grief? Some thoughts about the underdeveloped right ventricle in pulmonary atresia and intact ventricular septum. JACC 1992; 19: 1038–1040.CrossRefGoogle ScholarPubMed
5.Iwasaki, K; Kusachi, S; Hina, K; Murakami, M; Matano, S; Ohnishi, N; Kondo, N; Kita, T; Sakakibara, N. Coronary to bronchial artery anastomosis in patients with noncyanotic cardiopulmonary disease: report of seven cases. Can J Cardiol (Canada), Oct 1997, 13(10):898–900Google ScholarPubMed
6.Matsunaga, N; Hayashi, K; Sakamoto, I; Ogawa, Y; Matsuoka, Y; Imamura, T; Kuriya, T.Coronary-to-pulmonary artery shunts via the bronchial artery: analysis of cineangiographic studies. Radiology (United States), Mar 1993, 186(3):877–882Google ScholarPubMed
7.Bjork, L. Angiographic demonstration of extracardial anasto moses to the coronary arteries. Radiol 1966; 87: 274–277.Google Scholar
8.Zureikat, HY. Collateral arteries between thecoronary and bronchial arteries in patients with cyanotic congenital heart disease. Am J Cardiol 1980; 45: 599–60CrossRefGoogle ScholarPubMed
9.Lenox, CC and Briner, J. Absent Proximal Coronary Arteries Associated with Pulmonic Atresia. Am J Cardiol 1972; 30: 666–669.CrossRefGoogle ScholarPubMed
10.Najm, H, Williams, WG, Coles, JG, Rebeyka, I, Freedom, RM. Pulmonary atresia with intact ventricular septum: results of the Fontan procedure. Ann Thorac Surg 1997; 63: 669–675CrossRefGoogle ScholarPubMed