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Pts with transposition of the great arteries (TGA) may have varied coronary artery patterns; reimplantation during arterial switch operation (ASO) may necessitate acute angles of takeoff from the aortic root impacting left ventricular (LV) performance.
Retrospective review of CMR scans from 2005–2011 with TGA after ASO with coronary imaging, LV cines & phase contrast velocity mapping. Angle of takeoff measurement of the coronaries were made tangential to the aortic root in 2 orthogonal planes (axial & sagittal); the smaller angle was taken by protocol (see image). Significance = P<0.05.
57 pts, ages 13.8+6.8 yrs were found; 53 had 2 or 3 coronary ostia & 4 had a single coronary artery. Left coronary artery angle of takeoff significantly correlated with indexed LV mass; a lower angle implies a more acute coronary takeoff (see graph). No significant correlations were noted between angle of takeoff of either right, left or single coronary arteries with LV ejection fraction, indexed LV end-diastolic or end-systolic volumes or cardiac index at rest. When pts were divided into those with an angle of takeoff < 450 or > 450, no significant differences in LV function at rest or mass were noted.
Left coronary artery angle of takeoff in pts with TGA after ASO is not related to function at rest but is related to LV mass. This suggests that LV hypertrophy may change the angle of takeoff of the coronaries which may impact LV performance during exercise; a further study is warranted.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Cardiology Solutions: Prenatal Diagnosis, Coronary Anomalies and More
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1162-126
- 2013 American College of Cardiology Foundation