Corridor technique for coronary arteries from a single arterial sinus

2020 ◽  
Vol 28 (6) ◽  
pp. 333-335
Author(s):  
Kota Agematsu ◽  
Mitsugi Nagashima ◽  
Yoshiharu Nishimura ◽  
Takashi Higaki
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Arterial Switch Operation ◽  
Early Mortality ◽  
Single Coronary Artery ◽  
Coronary Anomalies ◽  
Arterial Switch ◽  
Switch Operation ◽  
Late Morbidity ◽  
Independent Risk Factors

The introduction of the arterial switch operation has improved the surgical outcome of transposition of the great arteries. However, coronary anomalies such as intramural coronary arteries, single coronary artery, or coronary arteries originating from a single arterial sinus have been reported as independent risk factors for early mortality and late morbidity after an arterial switch operation. We performed an arterial switch operation using a unique technique for translocation of the coronary arteries originating from a single left-side arterial sinus, to prevent coronary artery distortion and subsequent coronary malperfusion.

scholarly journals Single coronary artery and neonatal arterial switch operation: early and long-term outcomes†

2017 ◽  
Vol 52 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Sébastien Gerelli ◽  
Margaux Pontailler ◽  
Bruno Rochas ◽  
Emanuela Angeli ◽  
Mathieu Van Steenberghe ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Arterial Switch Operation ◽  
Single Coronary Artery ◽  
Long Term Outcomes ◽  
Arterial Switch ◽  
Switch Operation

scholarly journals The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Kwang Ho Choi ◽  
Si Chan Sung ◽  
Hyungtae Kim ◽  
Hyoung Doo Lee ◽  
Hoon Ko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Arterial Switch Operation ◽  
Early Mortality ◽  
Reconstruction Technique ◽  
Valve Regurgitation ◽  
Late Mortality ◽  
Arterial Switch ◽  
Switch Operation ◽  
Late Morbidity

Abstract Background The aim of this study was to determine if there was a difference between coronary reimplantation after neoaortic reconstruction and open coronary reimplantation technique in arterial switch operation (ASO). Methods A total of 236 patients who underwent ASO from March 1994 to August 2018 were enrolled in this study. Multivariate analysis was performed for postoperative early mortality. Patients were divided into the open coronary reimplantation and coronary reimplantation after neoaortic reconstruction groups. The 30-day mortality, intraoperative and postoperative coronary artery (CA) revisions, CA–related late morbidity and mortality, and early and late neoaortic valve regurgitations after ASO were compared between the two groups. Results Overall postoperative early mortality was 7.2% (17/236). Patients who underwent open coronary reimplantation had higher early mortality as compared with those who underwent coronary reimplantation after neoaortic reconstruction. Risk factors for postoperative early mortality from multivariate analysis were cardiopulmonary bypass time and open coronary reimplantation. There was a higher incidence of CA–related late mortality or morbidity in the open coronary reimplantation group. The open coronary reimplantation group had a higher incidence of intraoperative or postoperative CA revision. There were no differences in the incidence of mild or more neoaortic valve regurgitation at discharge or in the 5-year freedom from mild or more neoaortic valve regurgitation. Conclusions CA reimplantation after neoaortic reconstruction yields better results in mortality and intraoperative or postoperative CA–related problems in ASO without increasing postoperative neoaortic valve regurgitation.

Unusual Intramural Coronary Artery With Vertical Course Complicating an Arterial Switch Operation

2017 ◽  
Vol 10 (2) ◽  
pp. 231-234
Author(s):  
Lok Sinha ◽  
Richard A. Jonas ◽  
Pranava Sinha
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Arterial Switch Operation ◽  
Ascending Aorta ◽  
Sinus Of Valsalva ◽  
Arterial Switch ◽  
Switch Operation ◽  
Technical Modifications ◽  
Intramural Coronary Artery

Intramural coronary arteries in patients with d-transposition of the great arteries (d-TGA) usually arise from the opposite sinus of Valsalva and traverse horizontally across the posterior/facing commissure before emerging externally from the appropriate sinus of Valsalva. Failure to make appropriate technical modifications during coronary transfer can result in an important risk of posttransfer ischemia. We report a case with an unusual course of an intramural left anterior descending (LAD) coronary artery in a patient with d-TGA, with origin at the mid ascending aorta and a vertical intramural course, increasing the susceptibility to injury during an arterial switch operation (ASO).

scholarly journals Arterial switch operation with a single coronary artery

2002 ◽  
Vol 123 (6) ◽  
pp. 1164-1172 ◽  
Author(s):  
Albertus M. Scheule ◽  
David Zurakowski ◽  
Elizabeth D. Blume ◽  
Christof Stamm ◽  
Pedro J. del Nido ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Arterial Switch Operation ◽  
Single Coronary Artery ◽  
Arterial Switch ◽  
Switch Operation

Preoperative identification of coronary arterial anatomy in complete transposition, and outcome after the arterial switch operation

2002 ◽  
Vol 12 (3) ◽  
pp. 240-247 ◽  
Author(s):  
Colin J. McMahon ◽  
Howaida G. El Said ◽  
Timothy F. Feltes ◽  
Carmen H. Watrin ◽  
Beth A. Hess ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Left Coronary Artery ◽  
Arterial Switch Operation ◽  
Circumflex Coronary Artery ◽  
Arterial Switch ◽  
Complete Transposition ◽  
Switch Operation ◽  
The Right ◽  
Arterial Anatomy

Background: Perceived correlation between the coronary arterial anatomy in patients with complete transposition, and the outcome of the arterial switch procedure, has made preoperative identification of their patterns standard practice. Purpose: Our purpose was to assess the accuracy of preoperative echocardiographic identification of coronary arterial patterns, to evaluate the necessity of preoperative imaging by angiography, and to determine the impact of the coronary arterial anatomy on outcome. Methods: We reviewed the medical records of all patients referred for an arterial switch operation between August 1995 and January 2000. The anatomy as described at the time of the operation using the Leiden convention was compared to the preoperative echocardiographic and angiographic findings. Results: The procedure had been performed in 67 patients, at a mean age of 9 days, with a range from 3 days to 15 months. In 42 patients, the ventricular septum was intact, while 21 patients had a ventricular septal defect, and the other four had double outlet right ventricle with the aorta anterior and rightward. In 52 patients, the left coronary artery arose from sinus #1, and the right from sinus #2. In 8 patients, the interventricular branch of the left coronary artery arose from sinus #1, with the circumflex coronary artery arising together with the right coronary artery from sinus #2. In three patients, all three coronary arteries arose from sinus #1, while in the remaining individual patients, a large conal branch arose with the left coronary artery from sinus #1, the right coronary and left anterior descending arteries arose from sinus #1, all three coronary arteries took origin from sinus #2, and the left anterior descending and right coronary artery arose from sinus #1 with no circumflex coronary artery identifiable, respectively. In two patients (4%), we identified an intramural coronary arterial course. Echocardiography and angiography were comparable (81% versus 86%) in delineating the coronary arterial anatomy. Patients with a single arterial orifice, or an atypical coronary arterial anatomy, had a slightly longer stay on the intensive care unit, and in the hospital, but showed no difference in mortality. In fact, there was no early mortality (70% confidence limits; 0–2.9%), while two patients died late (2.9%). Conclusion: We conclude that complex coronary arterial anatomy does not preclude a successful arterial switch procedure, although patients with a single coronary artery, or other arterial patterns, had a slightly longer hospital course. Preoperative echocardiographic evaluation is comparable to non-selective coronary angiography. Irrespective of complexity, nonetheless, the coronary arteries can successfully be translocated, obviating the need for preoperative coronary angiography.

scholarly journals Transposition of Great Arteries with Left Main Coronary Artery Atresia—Case Report

2018 ◽  
Vol 07 (01) ◽  
pp. e16-e17
Author(s):  
Ahmed Elmahrouk ◽  
Tamer Hamouda ◽  
Mohamed Ismail ◽  
Ahmed Jamjoom
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Arterial Switch Operation ◽  
Great Artery ◽  
Single Coronary Artery ◽  
Left Main ◽  
Transposition Of Great Arteries ◽  
Case Presentation ◽  
Arterial Switch ◽  
Switch Operation

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.

Arterial Switch Operation With a Single Coronary Artery: The Autograft Concept

2009 ◽  
Vol 87 (6) ◽  
pp. 1967-1968 ◽  
Author(s):  
Loïc Macé ◽  
Fabrice Vanhuyse ◽  
Jean-Marc Jellimann ◽  
Dany Youssef ◽  
Anne Moulin-Zinsch ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Arterial Switch Operation ◽  
Single Coronary Artery ◽  
Arterial Switch ◽  
Switch Operation
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