Fate of Intramural Coronary Arteries after Arterial Switch Operation
| Autor: | Sabine Daebritz, Stefan Jockenhoevel, E. G. Mühler, A. Tiete, Jörg S. Sachweh, G von Bernuth, Bruno J. Messmer |
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| Rok vydání: | 2002 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Coronary Vessel Anomalies Transposition of Great Vessels medicine.medical_treatment Coronary Disease Dissection (medical) Coronary Angiography Revascularization Internal medicine Humans Medicine Myocardial infarction Coronary Artery Bypass Mammary Arteries Retrospective Studies Cardiac catheterization business.industry Infant Newborn medicine.disease Coronary arteries medicine.anatomical_structure Great arteries Coronary occlusion Cardiology Female Surgery Cardiology and Cardiovascular Medicine business Follow-Up Studies Artery |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 50:40-44 |
| ISSN: | 1439-1902 0171-6425 |
| DOI: | 10.1055/s-2002-20165 |
| Popis: | BACKGROUND To evaluate the impact of intramural coronary arteries for the peri-, postoperative and long-term course after arterial switch operation (ASO). METHODS ASO was performed in 351 patients between 1981 and 2000 with dextrotransposition of the great arteries (d-TGA). Five patients (1.4 %) had an intramural coronary artery. Coronary transfer was performed with a collar under dissection of the commissure without longitudinal splitting of the intramural section. RESULTS None of these patients died; the intraoperative course was uneventful, and no myocardial ischemic changes were observed. In three patients, follow-up cardiac catheterization after 5, 16 and 53 months revealed an occlusion of the intramural coronary ostium. Exercise electrocardiography and myocardial scintiscan showed myocardial ischemia. Two of these patients underwent a successful internal mammary artery bypass. CONCLUSIONS The intramural course of coronary arteries in patients with d-TGA is rare and does not cause increased mortality or myocardial infarction rates. However, the risk of coronary occlusion over time seems to be high. Therefore, patients with this condition require selective coronary angiography and frequent exercise investigations. Revascularization with an internal mammary artery bypass may be indicated. |
| Databáze: | OpenAIRE |
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