Right coronary ostia displacement——maybe an important factor of peri-operative mortality after SVAS correction in infant

Abstract

Objective Explore the influence of different surgical methods on right coronary artery opening after congenital supravalvular aortic stenosis correction surgery, to avoid right coronary artery obstruction caused by surgery. Methods A retrospective analysis was made on the surgical methods and results of continuous records of 91 supravalvular aortic stenosis surgery cases operated from 2008 to 2015, while analyzing the cause of early death, early reoperation, and ECMO assisted. Results 4 cases of perioperative death, 6 cases of ECMO assisted, 8 cases of reoperation, all above are concerned with early malignant arrhythmia .The surviving cases were followed up for 15 months, no death cases during the followed-up. Conclusion Different surgical methods have different influences on right coronary artery, related to the operation of right coronary incision. If the patch is oversize, it will cause obstruction of right coronary artery opening and cause malignant arrhythmia, however, undersized patch can not relieve aortic stenosis. So different surgical methods should be used according to different age and weight of patients. Key words: Congenital heart disease; Supravalvular aortic stenosis