Intracoronary Ultrasound Assessment Late After the Arterial Switch Operation for Transposition of the Great Arteries

Abstract

Intravascular ultrasound assessment late after the ASO revealed proximal eccentric intimal thickening in most of the studied vessels. This observation suggests the development of early atherosclerosis in the reimplanted coronary arteries, which may have a role in the genesis of late coronary events.

Outcomes of Patients After Arterial Switch Operation: 18 Years of Experience in a Single Medium-Volume Center

“…Although description of late coronary stenosis varies from 2 to 9 % [3], some series have not required late re-interventions on the coronary arteries at all [4]. Pedra et al [10] found proximal eccentric proliferation in the coronary arteries of all of 20 asymptomatic patients studied after ASO. Although we may have not diagnosed asymptomatic coronary lesions, clear guidelines for coronary evaluation and re-intervention are lacking [3,15].…”

Late coronary artery lesions after neonatal arterial switch operation: results of surgical coronary revascularization

“…Intracoronary ultrasound assessment late after ASO has revealed proximal eccentric intimal thickening in most (89%) coronary arteries. A total of 30% of arteries had significant proliferative lesions [4]. Progressive intimal proliferation may finally lead to severe coronary obstruction or even complete occlusion [11].…”

“…The incidence, pathophysiology, and treatment of coronary lesions remain matters of debate [1][2][3][4]. Therapeutic options include medical management, percutaneous transluminal dilation [5,6], and surgical revascularization [7,8].…”

Off-Pump Revascularization in a 2-Year-Old Girl After Neonatal Arterial Switch

“…Studies using intracoronary ultrasound have shown proximal eccentric intimal thickening in nearly 30% of arteries at late follow-up [7]. With an incidence of coronary lesions close to 5%, the number of children likely to require revascularization after ASO is expected to grow.…”