Cardiovascular Pharmacology: Open Access

Anomalous left coronary artery from the pulmonary artery (ALCAPA) in children of different age groups

Joint Event on Heart Failure, Pediatric Cardiology & Nursing Education

February 18-19, 2019 | Amsterdam, Netherlands

Ivanova-Razumova T V, Baigalkanova A I, Zhanatkyzy A and Mahambetova K

Kazakhstan

Posters & Accepted Abstracts: Cardiovasc Pharm Open Access

Abstract:

Introduction: In the absence of surgical correction of ALCAPA, the mortality rate for the first year of life is 90%, however with good development of collaterals, the defect can remain undiagnosed for a long time; for 10% of patients, the diagnosis verification occurs in adolescence. We decide to determine peculiarities of ALCAPA clinical course in different age groups of children.

Methods: Nineteen patients with ALCAPA were analyzed. Mean age was 21±7 months (1 month - 15 years). Two groups were identified: Group I - ALCAPA was diagnosed before the age of 2 years, Group II- patients with late manifestation. We evaluated them pre-, postoperatively and 3, 6, 12 months after. Statistica 6.0 was used for statistical analyses.

Results: Group I - 11 babies, mean age - 10±3.4 months, Group II - 8 children, mean age 5±1.2 y. Initially in Group I, patients had CHF III - IV (Ross), mean LV EF - 16±5%, mean pro-BNP level -15000±2.500 pg/ml. Group II preoperatively - CHF FC II, mean LV EF - 53±4,5%, pro-BNP level - 240±15 pg/ml. In that group, good collaterals were visualized by ECHO and angiogram. In the early postoperative period in Group I - EF LV - 19±2.3%, pro-BNP level of 10.200±1250 pg/ml (the differences were not reliable). In Group II, the LVEF and pro-BNP level remained practically unchanged. Three months after in Group I - LVEF-32±3.5% (p<0.05), the level of pro-BNP decreased significantly - 4500±860 pg/ml (p<0.05). Six months after in Group I - LVEF- 50±4.5% (p<0.05), the level of pro- BNP decreased significantly - 560±120 pg/ml (p<0.05). Twelve months after in Group I - LVEF-55±2.5% (p<0.05), the level of pro-BNP decreased significantly - 255±110 pg/ml (p<0.05).

Conclusions: Clinical favorable course of ALCAPA in Group II can be explained by the presence of collateral blood flow. Further study of the factors which determined collaterals formation represent great scientific interest