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 |
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| 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 |
| DOI: | 10.1017/s104795111900204x |
| 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 |
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