Vineberg procedure for inadvertent injury to anomalous left anterior descending artery during tetralogy of fallot repair: four decades later.
Year: 2006
Type: article
Study design: Case Report
Abstract: A 41-year-old man underwent diagnostic coronary angiography for the evaluation of chest pain. In 1965 (at the age of 2 years), he had undergone tetralogy of Fallot repair that had been complicated by accidental damage to the left anterior descending coronary artery (LAD), which arose anomalously from the right sinus of Valsalva (RSV) and crossed the right ventricular outflow tract. At that time, he underwent direct implantation of the left internal mammary artery into the left ventricular myocardium (Vineberg procedure) as a remedy.
The coronary angiogram showed a patent right coronary artery, a patent anomalous left circumflex artery arising from the RSV, and an occluded anomalous LAD from the RSV, which was reconstituted by collateral vessels from the left circumflex artery (Fig. 1). The left internal mammary artery that had been implanted directly into the left ventricular myocardium was found to be atretic (Fig. 2). The left ventricular ejection fraction was estimated at 0.50, with mild septal hypokinesis. Medical treatment was advised for the patient.
Fig. 1 Left anterior oblique view shows an occluded left anterior descending coronary artery (arrows) reconstituted by collateral vessels from the left circumflex artery.
Fig. 2 The left internal mammary artery (LIMA) graft that was implanted directly into left ventricular myocardium (Vineberg procedure) was atretic (arrow).
Source: Europe PMC (PubMed Central)
Institution: The University of Texas Medical Branch at Galveston
Language: English
Topic: Coronary Artery Anomalies
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W224256393