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

Autor: Konrad Szymczyk, Katarzyna Sobczak-Budlewska, Marek Niwald, Maciej Moll, Krzysztof W. Michalak, Jadwiga Moll, Jacek Moll, Paweł Dryżek
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Computed Tomography Angiography
Transposition of Great Vessels
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
Asymptomatic
Transposition (music)
Electrocardiography
Young Adult
03 medical and health sciences
Imaging
Three-Dimensional

Postoperative Complications
0302 clinical medicine
Left coronary artery
Predictive Value of Tests
Internal medicine
medicine.artery
medicine
Humans
Retrospective Studies
medicine.diagnostic_test
business.industry
Incidence
General Medicine
Coronary Vessels
Arterial Switch Operation
Survival Rate
medicine.anatomical_structure
030228 respiratory system
Echocardiography
Great arteries
Positron-Emission Tomography
Right coronary artery
Pediatrics
Perinatology and Child Health

Cardiology
Female
Poland
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Perfusion
Follow-Up Studies
Artery
Zdroj: Cardiology in the Young. 29:1350-1355
ISSN: 1467-1107
1047-9511
Popis: 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 (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.
Databáze: OpenAIRE