Detection of coronary complications after the arterial switch operation for transposition of the great arteries: First experience with multislice computed tomography in children

The main cause of long-term morbidity and mortality after a successful arterial switch operation for transposition of the great arteries is complications at the ostial segments, proximal segments, or both of the retransferred coronary arteries. The purpose of this study was to investigate the clinic...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 2006-03, Vol.131 (3), p.639-643
Main Authors: Ou, Phalla, Mousseaux, Elie, Azarine, Arshid, Dupont, Peggy, Agnoletti, Gabriella, Vouhé, Pascal, Sidi, Daniel, Bonnet, Damien
Format: Article
Language:English
Subjects:
Bioengineering
Biological and medical sciences
Cardiology. Vascular system
Child
Child, Preschool
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Coronary Angiography
Coronary Angiography - methods
Coronary heart disease
Coronary Stenosis
Coronary Stenosis - diagnostic imaging
Coronary Stenosis - etiology
Heart
Humans
Life Sciences
Medical sciences
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Tomography, X-Ray Computed
Transposition of Great Vessels
Transposition of Great Vessels - surgery
Vascular Surgical Procedures
Vascular Surgical Procedures - adverse effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The main cause of long-term morbidity and mortality after a successful arterial switch operation for transposition of the great arteries is complications at the ostial segments, proximal segments, or both of the retransferred coronary arteries. The purpose of this study was to investigate the clinical usefulness of multislice computed tomographic angiography in detecting ostial and proximal coronary lesions in children having undergone the arterial switch operation for transposition of the great arteries. Forty-nine children (aged 8.5 ± 3.9 years) operated on for transposition of the great arteries with the arterial switch operation (follow-up, 8.3 ± 3.6 years) underwent systematic selective conventional and multislice computed tomographic angiography. The ability of multislice computed tomography in detecting stenosis and other modifications of the coronary arteries’ course was analyzed by 2 independent investigators. Multislice computed tomography, as compared with selective conventional coronary angiography, permitted assessment of ostial and proximal coronary segments in every patient. It correctly detected the 4 (8.1%) patients with significant coronary lesions (1 with ostial and 3 with proximal coronary stenosis) that had been identified by means of conventional angiography. Multislice computed tomography clearly showed an abnormal course of the coronary artery between the great arteries with compression of the ostial (1 patient) and proximal (3 patients) segments of the retransferred coronary arteries. These results indicate that multislice computed tomographic angiography is fully accurate in detecting ostial coronary artery stenoses, proximal coronary artery stenoses, or both in pediatric patients having undergone the arterial switch operation for transposition of the great arteries. Our results suggest that multislice computed tomography could be used as a screening technique for detecting coronary complications in the follow-up of the arterial switch operation before having recourse to conventional angiography.
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2005.11.014