Arterial Switch Operations for Single Coronary Artery Ostium or Intramural Coronary Artery

Abstract

ecently, the arterial switch operation has become the first line surgical procedure for the correction of transposition of the great arteries (TGA) 1 and the determinants of success are the preoperative left ventricular performance, coronary artery anatomy and the experience of the surgical team. Complex coronary artery anatomy increases the operative risk. 1 Following repair of TGA with the usual coronary artery pattern in which the right and left coronary arteries arise from sinuses I and II respectively, kinking or tension of the coronary arteries is rarely seen; however, the risk increases in TGA with a single coronary ostium or intramural coronary artery patterns.

Arterial Switch Operation With and Without Coronary Relocation for Intramural Coronary Arteries

“…Many studies have pointed out concerns of late tunnel obstruction, late ostial stenosis, myocardial ischemia by compression of the great arteries, and late right ventricular outflow stenosis because of an oversized coronary pouch after ASO without coronary relocation [2,16]. In the present study, there was no late tunnel obstruction, thrombus formation, or myocardial ischemia in the 6 survivors.…”

Techniques and Pitfalls of Coronary Arterial Reimplantation in Anatomical Correction of Transposition

“…Presence of associated defects also created additional problems, as did side-by-side arterial trunks in the socalled Taussig-Bing variant. 4,12,31,47 With ongoing experience, many of these potential problems have been mitigated. It is now generally considered that translocation is feasible for all variable patterns, although origin from the nonadjacent sinus may now be considered a contra-indication.…”

“…46 • Cetin technique: Coronary arterial buttons are transferred to the neoaorta using pericardial or pulmonary arterial hoods (Figure 8C). 47…”

Prenatal assessment of coronary artery anatomy using color Doppler in cases of D‐transposition of the great arteries: Case reports

“…An accurate identification of CA anatomy is essential for planning the ASO because abnormal CA anatomy can make CA transfer (a critical aspect of the ASO) extremely difficult . Some types of abnormal CA anatomy, such as a single or intramural CA, necessitate various modified techniques in the CA transfer . In Case 2, although we adapted the Aubert procedure, a single CA was the main cause of the failure in the ASO.…”