Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-27T10:40:30.126Z Has data issue: false hasContentIssue false
  • English
  • Français

Can we predict potentially dangerous coronary patterns in patients with transposition of the great arteries after an arterial switch operation?

Published online by Cambridge University Press:  11 September 2019

Krzysztof W. Michalak Open the ORCID record for Krzysztof W. Michalak [Opens in a new window] ,
Katarzyna Sobczak-Budlewska ,
Jacek J. Moll ,
Konrad Szymczyk ,
Jadwiga A. Moll ,
Marek Niwald ,
Paweł Dryżek  and
Maciej Moll
Krzysztof W. Michalak*
Affiliation:
Department of Cardiology, Polish Mother’s Memorial Hospital, Lodz, Poland
Katarzyna Sobczak-Budlewska
Affiliation:
Department of Cardiology, Polish Mother’s Memorial Hospital, Lodz, Poland
Jacek J. Moll
Affiliation:
Department of Cardiac Surgery, Polish Mother’s Memorial Hospital, Lodz, Poland
Konrad Szymczyk
Affiliation:
Department of Diagnostic Imaging, Polish Mother’s Memorial Hospital, Lodz, Poland
Jadwiga A. Moll
Affiliation:
Department of Cardiology, Polish Mother’s Memorial Hospital, Lodz, Poland
Marek Niwald
Affiliation:
Department of Cardiology, Polish Mother’s Memorial Hospital, Lodz, Poland
Paweł Dryżek
Affiliation:
Department of Cardiology, Polish Mother’s Memorial Hospital, Lodz, Poland
Maciej Moll
Affiliation:
Department of Cardiac Surgery, Polish Mother’s Memorial Hospital, Lodz, Poland
*
Author for correspondence: K. W. Michalak, MD, PhD, Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, 93-338 Lodz, ul. Rzgowska 281/289, Lodz, Poland. Tel: 00-48-42-271-14-78; Fax: 00-48-42-271-14-70; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Coronary artery complications are the main reason for early mortality after an arterial switch operation. Late complications are relatively rare, and there is no consensus regarding the need or indications for routine follow-up coronary artery evaluations or the best first-line assessment modality. The aim of this study was to present the long-term post-operative frequency of coronary abnormalities in asymptomatic patients with transposition of the great arteries discovered by coronary CT angiography and potential “red flags” revealed by other examinations.

Patients and methods:

A group of 50 consecutive asymptomatic patients who underwent routine long-term coronary artery evaluation after an arterial switch operation according to our institutional protocol were qualified for this study. This routine in-hospital visit included a detailed medical interview, electrocardiography, echocardiography, Holter electrocardiography examinations, and laboratory and cardiopulmonary exercise tests. Patients who showed significant abnormalities were qualified for perfusion scintigraphy.

Results:

Unfavourable coronary abnormalities were detected in 30 patients (60%) and included ostial stenosis, muscular bridge, coronary fistula, interarterial course, proximal kinking, high ellipticity index, proximal acute angulation (<30 degree) of the left coronary artery, and proximal acute angulation of the right coronary artery. These features could not be predicted based on the medical interviews, surgical reports, or non-invasive screening test results.

Conclusion:

Complex coronary configurations with potentially dangerous coronary features are common in patients with transposition after an arterial switch operation. Such high-risk patients cannot be identified indirectly, and coronary CT angiography provides accurate information that is useful for post-operative management.

Keywords

Transposition of the great arteriesarterial switch operationcoronary anomaliescoronary complications
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 11 , November 2019 , pp. 1350 - 1355
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fricke, TA, Bulstra, AE, Naimo, PS, et al. Excellent long-term outcomes of the arterial switch operation in patients with intramural coronary arteries. Ann Thorac Surg 2016; 101: 725–729.CrossRefGoogle ScholarPubMed
Villafañe, J, Lantin-Hermoso, MR, Bhatt, AB, et al. D-transposition of the great arteries: the current era of the arterial switch operation. J Am Coll Cardiol 2014; 64: 498–511.CrossRefGoogle ScholarPubMed
van Wijk, SWH, van der Stelt, F, Ter Heide, H, et al. Sudden death due to coronary artery lesions long-term after the arterial switch operation: a systematic review. Can J Cardiol 2017; 33: 1180–1187.CrossRefGoogle ScholarPubMed
Van Hare, GF, Ackerman, MJ, Evangelista, JA, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 4: congenital heart disease: a scientific statement from the American Heart Association and American College of Cardiology. Circulation 2015; 132: e281–e291.CrossRefGoogle ScholarPubMed
Szymczyk, K, Moll, M, Sobczak-Budlewska, K, et al. Usefulness of rotine coronary CT angiography in patients with transposition of the great arteries after an arterial switch operation. Pediatr Cardiol 2018; 39: 335–346.CrossRefGoogle ScholarPubMed
Ou, P, Khraiche, D, Celermajer, DS, et al. Mechanisms of coronary complications after the arterial switch for transposition of the great arteries. J Thorac Cardiovasc Surg 2013; 145: 1263–1269.CrossRefGoogle ScholarPubMed
Ou, P, Mousseaux, E, Azarine, A, et al. Detection of coronary complications after the arterial switch operation for transposition of the great arteries: first experience with multislice computed tomography in children. J Thorac Cardiovasc Surg 2006; 131: 639–43.CrossRefGoogle ScholarPubMed
Watson, TG, Mah, E, Joseph Schoepf, U, King, L, Huda, W, Hlavacek, AM. Effective radiation dose in computed tomographic angiography of the chest and diagnostic cardiac catheterization in pediatric patients. Pediatr Cardiol 2013; 34: 518–524.CrossRefGoogle ScholarPubMed
Moll, JJ, Michalak, KW, Młudzik, K, et al. Long-term outcome of direct neopulmonary artery reconstruction during the arterial switch procedure. Ann Thorac Surg 2012; 93: 177–184.CrossRefGoogle ScholarPubMed
Lee, S, Uppu, SC, Lytrivi, ID, et al. Utility of multimodality imaging in the morphologic characterization of anomalous aortic origin of a coronary artery. World J Pediatr Congenit Heart Surg 2016; 7: 308–317.CrossRefGoogle ScholarPubMed
Eckart, RE, Scoville, SL, Campbell, CL, et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 2004 Dec 7; 141: 829–834.CrossRefGoogle ScholarPubMed
Kastellanos, S, Aznaouridis, K, Vlachopoulos, C, Tsiamis, E, Oikonomou, E, Tousoulis, D. Overview of coronary artery variants, aberrations and anomalies. World J Cardiol 2018; 10: 127–140.CrossRefGoogle ScholarPubMed
Monroy-Gonzalez, AG, Alexanderson-Rosas, E, Prakken, NHJ, et al. Myocardial bridging of the left anterior descending coronary artery is associated with reduced myocardial perfusion reserve: a 13N-ammonia PET study. Int J Cardiovasc Imaging 2019; 35: 375–382.CrossRefGoogle ScholarPubMed
Moll, M, Michalak, KW, Sobczak-Budlewska, K, et al. Coronary artery anomalies in patients with transposition of the great arteries and their impact on postoperative outcomes. Ann Thorac Surg 2017; 104: 1620–1628.CrossRefGoogle ScholarPubMed
Hegde, SV, Lensing, SY, Greenberg, SB. Determining the normal aorta size in children. Radiology 2015; 274: 859–865.CrossRefGoogle ScholarPubMed
Sarris, GE, Balmer, C, Bonou, P, et al. Clinical guidelines for the management of patients with transposition of the great arteries with intact ventricular septum. Cardiol Young 2017; 27: 530–569.Google ScholarPubMed
Cohen, MS, Eidem, BW, Cetta, F, et al. Multimodality imaging guidelines of patients with transposition of the great arteries: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance and the society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr 2016; 29: 571–621.CrossRefGoogle ScholarPubMed
Di Salvo, G, Miller, O, Babu Narayan, S, et al. Imaging the adult with congenital heart disease: a multimodality imaging approach-position paper from the EACVI results. Eur Heart J Cardiovasc Imaging 2018; 19: 1077–1098.CrossRefGoogle Scholar
Ashrafpoor, G, Danchin, N, Houyel, L, Ramadan, R, Belli, E, Paul, JF. Anatomical criteria of malignancy by computed tomography angiography in patients with anomalous coronary arteries with an interarterial course. Eur Radiol 2014; 25: 760–766.CrossRefGoogle ScholarPubMed
Tsuda, T, Bhat, AM, Robinson, BW, Baffa, JM, Radtke, W. Coronary artery problems late after arterial switch operation for transposition of the great arteries. Circ J 2015; 79: 2372–2379.CrossRefGoogle ScholarPubMed