Author + information
- Mieke MP Driessen,
- Johannes MPJ Breur,
- Roland RJ van Kimmenade,
- Gertjan Tj Sieswerda,
- Folkert J. Meijboom and
- Tim Leiner
Reimplantation of the coronary arteries in the neo-aortic root is an important part of the arterial switch operation (ASO) for transposition of the great arteries. Postoperative coronary pathology is a potentially lethal complication with incidences reported of 3.3 to 18%. This study evaluates the presence of coronary obstruction and myocardial infarction or left ventricular (LV) dysfunction using multimodality imaging in patients decades after ASO.
Thirty-two patients after ASO were included. All patients underwent 256-slice computed tomography angiography (CTA). Cardiac magnetic resonance imaging was performed for late gadolinium enhancement (LGE) and measurement of LV ejection fraction (LVEF).
All patients (63% male; mean follow-up 23.5 ± 4.9 yrs) were free of complaints of chest pain or dyspnea. Distribution of coronary artery origins is illustrated in the figure, 7 patients had an unusual coronary anatomy. Calciumscore was 0 in all patients. No coronary stenosis – either of the origo or in the course of the arteries – was seen on CTA. One patient had an interarterial course of the LAD. Seven patients (22%) had a decreased LVEF (<50%), but LGE was not demonstrated in any of the patients.
In contrast to previous reports, the current study found no coronary pathology using CTA in patients up to 33 years after ASO. Although 22% of the patients had a decreased LVEF, coronary obstruction or past myocardial infarction could not be demonstrated by CTA or LGE.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Congenital Cardiology Solutions: Outcomes and Resource Utilization in the Adults
Abstract Category: 12. Congenital Cardiology Solutions: Adult
Presentation Number: 1290-117
- 2013 American College of Cardiology Foundation