Related Experiment Videos
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
Insights
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.
- 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.
Abstract:
We report two cases presenting bilateral coronary artery obstruction after arterial switch operation. The first patient underwent bilateral internal thoracic artery grafting to the left and right coronary arteries. The other patient, presenting a single coronary ostium, underwent surgical coronary ostial angioplasty in concomitance to proximal arterioplasty of both coronary arteries employing a single "pantaloon" shape autologous pericardial patch. Both patients survived and, at 1 year and 9 months after the coronary revascularization procedures, the coronary angiography demonstrated a good patency of the internal thoracic grafts and excellent ostial plasty results, respectively. A complete literature review of patients undergoing different coronary revascularization procedures after arterial switch operation is reported.