Coronary dominance patterns in hypoplastic left heart syndrome.

INTRODUCTION

Although hypoplastic left heart syndrome (HLHS) be extensively studied, this disease still has a high mortality rate compared to other diseases treated as univentricular physiology. In this way, morphological differences between phenotypes within the spectrum of HLHS may be risk factors and their identification can assist in choosing treatment between subgroups.

OBJECTIVE

To identify the most prevalent form of coronary artery dominance in hearts with HLHS groups with mitral atresia (MA) and mitral stenosis (MS).

METHODS

Analysis of coronary anatomy according to the distribution of epicardial branches and the pattern of dominance, classified as right, left or balanced. The control group was composed of nine pieces of morphologically normal hearts, the HLHS group consisted of 9 pieces with MA and 24 pieces with MS. For statistical analysis we used the x² test.

RESULTS

There were significant differences between the two groups in relation to coronary artery dominance (x² = 9.298, P = 0.01). Left dominance was present in 75% of cases of MS, and balanced one was only observed in pieces with MS. The control group had right dominance in all cases (P <0.01).

CONCLUSIONS

Left dominance is more common in HLHS than in the control group of normal hearts and in HLHS. The left coronary dominance is more frequent in the subgroup with mitral stenosis.