Arterial switch operation for transposition of great arteries: Is coronary artery circulation evaluation necessary?

Background The coronary artery anatomy in patients with transposition of the great artery (TGA) is a contributing factor for outcome in arterial switch procedure. Case Presentation A full-term, 7-day-old baby boy diagnosed as dextro-TGA (dTGA) with intact ventricular septum. Intraoperatively, the left coronary sinus had a blind indentation from which a firm cord-like left main coronary artery originates. Procedure completed as usual for a routine arterial switch operation. Conclusion About 5% of patients with D-TGA have a single coronary artery. Assessment of blood flow to all branches intraoperatively is mandatory to choose between either transfer of single ostium or bypass grafting to the other coronary system.

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Coronary artery spasm in a neonate with transposition of great arteries: a rare complication and reason for heart transplant

Cardiology in the Young ◽

10.1017/s1047951117001652 ◽

2017 ◽

Vol 28 (1) ◽

pp. 163-167

Author(s):

Neha Bansal ◽

Ralph E. Delius ◽

Sanjeev Aggarwal

Keyword(s):

Coronary Artery ◽

Cardiac Transplantation ◽

Arterial Switch Operation ◽

Coronary Artery Spasm ◽

Left Ventricular ◽

Transposition Of Great Arteries ◽

Arterial Switch ◽

Coronary Artery Vasospasm ◽

First Case ◽

Switch Operation

AbstractArterial switch operation has become the standard of care for d-transposition of great arteries and has excellent short- and long-term outcomes. We report the case of a newborn with a diagnosis of d-transposition of great arteries with intact ventricular septum and a low-risk coronary artery anatomy who developed coronary artery vasospasm while coming off bypass following arterial switch operation in the operating room. The coronary artery spasm led to severe biventricular dysfunction and need for extracorporeal membranous oxygenation support. Despite extracorporeal membranous oxygenation and inotropic support, there was no improvement in the left ventricular function, and cardiac transplantation was performed after 8 days. The explanted heart showed extensive infarction of both ventricles. Both the coronary ostei were patent with no evidence of thrombus, suggesting coronary artery vasospasm rather than embolus or thrombus formation. This is the first case of coronary artery vasospasm in a neonate with d-transposition of great arteries leading to cardiac transplantation. We speculate that early identification of patients who are at a high risk for coronary vasospasm and prophylactic or timely infusion of papaverine directly into the coronary arteries may be beneficial in this condition.

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A new technique of arterial switch operation for transposition of great arteries with single coronary artery

Indian Journal of Thoracic and Cardiovascular Surgery ◽

10.1007/s12055-004-0357-4 ◽

2004 ◽

Vol 20 (1) ◽

pp. 22-22

Author(s):

KS Murthy ◽

K Bhatt ◽

V Singh ◽

S Kulkarni ◽

KM Cherian

Keyword(s):

Coronary Artery ◽

Arterial Switch Operation ◽

New Technique ◽

Single Coronary Artery ◽

Transposition Of Great Arteries ◽

Arterial Switch ◽

Switch Operation ◽

A New Technique

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Results of a new technique of arterial switch operation for transposition of great arteries with single coronary artery

Indian Journal of Thoracic and Cardiovascular Surgery ◽

10.1007/s12055-006-0751-1 ◽

2006 ◽

Vol 22 (3) ◽

pp. 165-168

Author(s):

Anil Kumar Dharmapuram ◽

Sunil Kumar Swain ◽

Nagarajan Ramdoss ◽

Pramod M.Ch Reddy ◽

Sreekanth Sundara Raghavan ◽

...

Keyword(s):

Coronary Artery ◽

Arterial Switch Operation ◽

New Technique ◽

Single Coronary Artery ◽

Transposition Of Great Arteries ◽

Arterial Switch ◽

Switch Operation ◽

A New Technique

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Right Coronary Artery May Grow Even Better than Normal After Arterial Switch Operation for Complete Transposition of the Great Arteries

10.21203/rs.3.rs-96030/v1 ◽

2020 ◽

Author(s):

Daisuke Machida ◽

Yukihisa Isomatsu ◽

Motohiko Goda ◽

Shinichi Suzuki ◽

Keiichiro Kasama ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Coronary Arteries ◽

Arterial Switch Operation ◽

Control Group ◽

Transposition Of Great Arteries ◽

Arterial Switch ◽

Complete Transposition ◽

Switch Operation ◽

The Right

Abstract Background: It is unclear if coronary arteries properly grow in patients who underwent arterial switch operation for complete transposition of the great arteries. The purpose of this study was to clarify the mode of coronary growth and size in these patients. Methods: Eighteen patients who underwent arterial switch operation for complete transposition of the great arteries from 2000 to 2012 in our institution, and in whom coronary angiography was performed in late operative phase, were enrolled in this study. Growth of coronary arteries was evaluated by cubage of coronary arteries based on analyses with coronary angiography. Coronary arteries were divided into small segments and each segment was approximated by a truncated right circular cone. The sum of the cubage of each truncated cone in one coronary artery was approximated as total cubage of the coronary. the coronary cubage index was then calculated by dividing total cubage of a coronary artery by the patient’s body surface area. The coronary cubage indexes of the enrolled patients were compared with that of control patients with healed Kawasaki disease.Results: The left coronary cubage indexes of the complete transposition of the great arteries group and the control group were 1.05 ± 0.34 and 0.94 ± 0.34 (p=0.598), respectively, and no significant deference was found between groups. On the contrary, the right cubage index of the complete transposition of great arteries group was significantly larger than the control group (1.08 ± 0.44 and 0.54 ± 0.37, respectively; p=0.007), and total coronary cubage index (left coronary index + right coronary index) of the complete transposition of the great arteries group was also larger than the control group as well (2.13 ± 0.7 and 1.47 ± 0.6, respectively; p=0.026).Conclusion: The left coronary arteries after arterial switch operation for complete transposition of great arteries grow as large as normal; however, the right coronary arteries possibly grow even larger.

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