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Coronary revascularization after arterial switch operation.

Edvin Prifti1, Massimo Bonacchi, Stefano Vincenzo Luisi

  • 1G. Pasquinucci Hospital, CREAS-IFC-CNR, Via Aurelia Sud, Massa 54100, Italy. edvinprifti@hotmail.com

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 15, 2002
PubMed
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Two cases of coronary artery obstruction after arterial switch operation were successfully treated with coronary revascularization procedures. Both patients showed good graft patency and ostial plasty results at follow-up.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Arterial switch operation (ASO) is a common surgical procedure for d-transposition of the great arteries.
  • Coronary artery complications, including obstruction, can occur after ASO.
  • Effective revascularization strategies are crucial for long-term outcomes.

Observation:

  • Two pediatric patients developed bilateral coronary artery obstruction post-ASO.
  • Case 1: Bilateral internal thoracic artery grafting to coronary arteries.
  • Case 2: Surgical coronary ostial angioplasty with a pericardial patch for a single coronary ostium.

Findings:

  • Both patients survived the revascularization procedures.
  • Coronary angiography at 1 year and 9 months showed good patency of internal thoracic artery grafts.

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  • Excellent results were observed for the ostial plasty procedure.

    • Implications:

    • Internal thoracic artery grafting and surgical ostial angioplasty are viable options for coronary revascularization post-ASO.
    • Successful revascularization can lead to favorable long-term outcomes.
    • Further research and literature review support these findings in managing coronary complications after ASO.