Late complication of intramural coronary transfer during the arterial switch operation

Stoll, Victoria; Hudsmith, Lucy; Drury, Nigel E; Barron, David J.

doi:10.1093/icvts/ivy289

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…The literature search identified four case reports [ 46 , 47 , 48 , 49 ] ( Table 4 ) in which a successful coronary intervention was reported in adults with a significant coronary lesion. Two patients were diagnosed with a significant stenosis of the left main stem.…”

Section: Resultsmentioning

confidence: 99%

The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review

Engele

Mulder

Schoones

et al. 2021

JCDD

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Coronary artery status in adults long after the arterial switch operation (ASO) is unclear. We conducted a systematic review to provide an overview of coronary complications during adulthood and to evaluate the value of routine coronary imaging in adults after ASO, in light of current guidelines. Articles were screened for the inclusion of adult ASO patients and data on coronary complications and findings of coronary imaging were collected. A total of 993 adults were followed with a median available follow-up of only 2.0 years after reaching adulthood. Myocardial ischemia was suspected in 17/192 patients (8.9%). The number of coronary interventions was four (0.4%), and coronary death was reported in four (0.4%) patients. A lack of ischemia-related symptoms cannot be excluded because innervation studies indicated deficient cardiac innervation after ASO, although data is limited. Anatomical high-risk features found by routine coronary computed tomography (cCT) included stenosis (4%), acute angle (40%), kinking (24%) and inter-arterial course (11%). No coronary complications were reported during pregnancy (n = 45), although, remarkably, four (9%) patients developed heart failure. The 2020 European Society of Cardiology (ESC) guidelines state that routine screening for coronary pathologies is questionable. Based on current findings and in line with the 2018 American ACC/AHA guidelines a baseline assessment of the coronary arteries in all ASO adults seems justifiable. Thereafter, an individualized coronary follow-up strategy is advisable at least until significant duration of follow-up is available.

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Section: Resultsmentioning

confidence: 99%

The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review

Engele

Mulder

Schoones

et al. 2021

JCDD

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Outcomes of the arterial switch for transposition during infancy using a standardized approach over 30 years

Drury

Mussa

Stickley

et al. 2023

Interdisciplinary CardioVascular and Thoracic Surgery

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OBJECTIVES To describe the early and late outcomes of the arterial switch for transposition. METHODS A single-centre retrospective cohort study was conducted to assess the early and late outcomes of arterial switch performed during infancy using a standardised institutional approach between 1988 and 2018, compared by morphological groups. RESULTS 749 consecutive patients undergoing arterial switch during infancy were included, 464 (61.9%) with intact septum, 163 (21.8%) with isolated ventricular septal defect, and 122 (16.3%) with complex transposition with associated lesions, including 67 (8.9%) with Taussig-Bing anomaly. There were 34 early deaths (4.5%, 95% CI 3.1–6.1) with only 10 (2.6%) early deaths since 2000. Complex morphology (OR 11.44, CI 4.76–27.43) and intramural coronary artery (OR 5.17, CI 1.61–15.91) were identified as the most important risk factors for 90-day mortality. Overall survival was 92.7% (95% CI 90.8–94.6) at 5 years and 91.9% (95% CI 89.9–94.1) at 20 years; in hospital survivors, there were 15 (2.1%) late deaths during a median follow-up of 13.7 years. Cumulative incidence of surgical or catheter reintervention was 16.0% (95% CI 14.5–17.5) at 5 years and 22.7% (95% CI 21.0–24.0) at 20 years; early and late reinterventions were more common in the complex group, with no difference between the other groups. CONCLUSIONS Using a standardised approach, the arterial switch can be performed with low early mortality, moderate rates of reintervention, and excellent long-term survival. Concomitant lesions were the most important risk factor for early death and were associated with increased risk of late reintervention.

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Late complication of intramural coronary transfer during the arterial switch operation

Cited by 2 publications

References 5 publications

The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review

The Coronary Arteries in Adults after the Arterial Switch Operation: A Systematic Review

Outcomes of the arterial switch for transposition during infancy using a standardized approach over 30 years

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