Angiographic evidence of long-axis rotation in addition to short-axis aortopulmonary rotation: Its implication in transposition of the great arteries

The coronary artery anatomy of complete transposition with situs solitus/levocardia (CTSSL) has been well elucidated in the current era of arterial switch operation. However, coronary artery for complete transposition with situs solitus/dextrocardia (CTSSD) has never been documented. Coronary anatomy of transposition and aortopulmonary rotation were identified by angiography or surgical intervention from 1988 to 2007 at our hospital. The degree of aortopulmonary rotation was defined by the aortic sinus pattern on lateral angiogram. Apicocaval ipsilaterality was defined as situs solitus/dextrocardia or situs inversus/levocardia. The coronary artery anatomy in 3 cases of CTSSD was analyzed and correlated with those patients having transposition with the same coronary pattern but without apicocaval ipsilaterality, i.e., 276 cases with CTSSL and 8 cases with complete transposition with situs inversus/dextrocardia (CTSID). Fisher's exact test was used to determine statistical significance. All three cases with CTSSD (with apicocaval ipsilaterality) had a single coronary artery piercing into the left-hand sinus with a right coronary artery in the posterior atrioventricular groove, whereas all 284 cases without apicocaval ipsilaterality (CTSSL or CTSID) had the left circumflex artery in the posterior atrioventricular groove. The aorta was significantly less left laterally rotated in CTSSD than the other 2 cases of CTSSL and 3 cases of CTSSD with a similar coronary pattern (p < 0.05). One may anticipate coronary artery anatomy in the posterior atrioventricular groove based on apicocaval ipsilaterality, which in turn decreases aortopulmonary rotation to predict the central coronary pattern.

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Coronary Artery Anatomy in Complete Transposition with Situs Solitus and Dextrocardia

Lee

Chiu

Chang

et al. 2010

Pediatr Cardiol

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Can We Better Understand the Known Variations in Coronary Arterial Anatomy?

Chiu

Anderson

2012

The Annals of Thoracic Surgery

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Coronary artery anatomy in anatomically corrected malposition of the great arteries and their surgical implications

Huang

Chiu

Lee

et al. 2011

European Journal of Cardio-Thoracic Surgery

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Angiographic evidence of long-axis rotation in addition to short-axis aortopulmonary rotation: Its implication in transposition of the great arteries

Cited by 10 publications

References 14 publications

Coronary Artery Anatomy in Complete Transposition with Situs Solitus and Dextrocardia

Coronary Artery Anatomy in Complete Transposition with Situs Solitus and Dextrocardia

Can We Better Understand the Known Variations in Coronary Arterial Anatomy?

Coronary artery anatomy in anatomically corrected malposition of the great arteries and their surgical implications

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