Arterial switch operation: successful bilateral internal thoracic artery grafting

Rescue Coronary Artery Bypass Grafting in a Neonate After Arterial Switch Operation: A Temporary or a Lifetime Solution?

“…Coronary complications and myocardial revascularization techniques have been extensively described after ASO for D-TGA. [4][5][6][7][8][9] Surgical procedures in neonates, which require reimplantation and manipulation of coronary arteries, may be associated with potential serious complications especially in case of abnormalities of origin, position, or distribution of these arteries. 1,9 During the last two decades, CABG has been described as a successful rescue option in neonates with D-TGA who had coronary artery ischemia at the time of ASO and has favorably impacted the clinical course of those patients with coronary insufficiency.…”

“…1,9 During the last two decades, CABG has been described as a successful rescue option in neonates with D-TGA who had coronary artery ischemia at the time of ASO and has favorably impacted the clinical course of those patients with coronary insufficiency. [4][5][6] In particular, the utilization of the left internal thoracic artery for CABG in children seems to have the higher patency rate as well as demonstrated anastomotic and linear growth potential. 7 Nonetheless there is still concern about its patency in patients younger than three years of age.…”

“…[2][3] Coronary artery bypass grafting (CABG) is considered a good surgical option for patients who had an iatrogenic coronary lesion after coronary translocation that did not resolve after conventional surgical maneuvers. [4][5][6][7] We present a case of a neonate with D-TGA, ventricular septal defect, and abnormal coronary artery pattern who underwent successful rescue CABG for acute ischemia at the time of ASO. Early and long-term clinical results are detailed.…”

Collateral Damage in a Neonate with Transposition of the Great Arteries

“…Since transthoracic echocardiography accurately demonstrates the morphology in simple TGA, preoperative cardiac catheterization is rarely performed. Major aortopulmonary collateral arteries can be left undiagnosed by routine transthoracic echocardiography . Even small collateral arteries can be overlooked and only an aortogram often with balloon occlusion can clearly delineate their number, size, and location.…”

“…Major aortopulmonary collateral arteries can be left undiagnosed by routine transthoracic echocardiography. 6 Even small collateral arteries can be overlooked and only an aortogram often with balloon occlusion can clearly delineate their number, size, and location. The presence of a PDA could result in under detection of aortopulmoanry collateral arteries by transthoracic echocardiography as the competitive flow via the usually larger PDA can result in low velocity flow into the collateral arteries.…”