A Successful Delivery in a Patient with Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Treated with Takeuchi Repair

DOI Web Site
  • Kajiyama Yo
    Department of Pediatrics, Kyoto Prefectural University of Medicine
  • Takigami Masao
    Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
  • Nakanishi Naohiko
    Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
  • Itatani Keiichi
    Department of Pediatric Cardiovascular Surgery, Kyoto Prefectural University of Medicine
  • Waratani Miyoko
    Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine
  • Yamagishi Masaaki
    Department of Pediatric Cardiovascular Surgery, Kyoto Prefectural University of Medicine

この論文をさがす

抄録

<p>A 30-year-old woman with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) treated with Takeuchi repair when she was one-month-old was referred to the obstetric department of our hospital for the management of her first pregnancy. She had a surgical operation for severe pulmonary regurgitation and tricuspid regurgitation one year before the pregnancy. The preoperative study showed a deterioration of right ventricular (RV) function, while presenting good performance of the left ventricle (LV). The cardiac function was found fully recovered through a postoperative study. A multidisciplinary medical team made close observations from the 3rd trimester to after the delivery. A successful vaginal delivery occurred at 39 gestational weeks with a completely healthy baby without any maternal cardiac events. The serum brain natriuretic peptide level did not elevate significantly during the pregnancy. The echocardiography showed that the LV ejection fraction, the LV internal dimension in diastole, and the global longitudinal strain (GLS) of LV remained in normal ranges. No significant valvar insufficiencies or stenoses were found. The GLS of the free wall of RV changed from −19.7% to −10.7% during the delivery and recovered to −23.8% one month after the delivery. Analogously, the fractional area change worsened from 58.3% to 25.4% and returned up to 57.1%. The tolerance of the cardiac load in pregnancy and delivery was ensured by the excellent postoperative course of ALCAPA with Takeuchi repair as well as the successful pulmonary and tricuspid valve reoperation in adulthood with fine assessment of the RV function.</p>

収録刊行物

キーワード

詳細情報 詳細情報について

問題の指摘

ページトップへ