Related Experiment Video
Updated: Dec 28, 2025
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Intramural coronary pattern in patients with transposition: incidence and impact on follow-up
Maciej Moll1, Jadwiga A Moll2, Jacek J Moll1
1Department of Cardiac Surgery, Polish Mother's Memorial Hospital, Research Institute, Lodz, Poland.
Insights
Intramural coronary patterns in transposition of the great arteries increase mortality after arterial switch operations. This study found these patterns are associated with higher overall mortality compared to other coronary variants.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Coronary complications are a primary cause of early mortality following arterial switch operations.
- Transposition of the great arteries often presents with coronary anomalies, complicating surgical procedures.
- Intramural coronary patterns, a rare variant, have been debated regarding their impact on survival rates.
Purpose of the Study:
- To determine the frequency of intramural coronary patterns in patients undergoing arterial switch operations for transposition of the great arteries.
- To assess the impact of intramural coronary patterns on overall mortality after this procedure.
- To document associated coronary arrangements and surgical management strategies.
Main Methods:
- Retrospective review of all arterial switch operations.
- Analysis of surgical reports including detailed graphical representations and coronary anatomy.
- Inclusion of all operatively confirmed intramural coronary patterns.
Main Results:
- Of 806 patients, 33.62% had coronary anomalies, and 3.47% had intramural patterns.
- Intramural patterns were frequently linked with other complex coronary anomalies (P < 0.001).
- Overall survival was significantly higher in patients with intramural patterns compared to other variants (21.34% vs 8.74%, P = 0.024).
Conclusions:
- Intramural patterns in transposition present surgical challenges and are associated with increased overall mortality in this cohort.
- Further multicenter data analysis is necessary to definitively confirm the significance of this rare coronary variant's impact.
- Successful surgical management techniques for these complex cases were presented.
Objectives:
Coronary complications are still the main reason for early mortality after an arterial switch operation. The high incidence of coronary anomalies in patients with transposition of the great arteries may increase the difficulty of coronary transfer, and among them, an intramural pattern was shown to be an independent risk factor of early mortality. However, recently published studies have reported that this rare coronary variant has no impact on the survival rate. The aim of this study was to assess the frequency of intramural coronary patterns in patients with transposition and the impact on overall mortality after an arterial switch operation. Additionally, we presented all coronary arrangements associated with intramural patterns in our cohort and the surgical techniques used to manage them successfully.
Methods:
All arterial switch operations were retrospectively reviewed. In each case, the surgical reports contained detailed graphical representations and coronary anatomy patterns. All operatively confirmed intramural patterns were included in the analysis.
Results:
Among 806 patients, 271 patients had coronary anomalies (33.62%), and 28 patients had an intramural pattern (3.47%), which was frequently associated with other complex coronary anomalies (P < 0.001). Overall survival was significantly higher in patients with intramural coronary artery patterns than in those with other coronary variants (21.34% vs 8.74%, P = 0.024, log-rank test).
Conclusions:
Intramural patterns associated with transposition remain a surgical challenge and increase overall mortality in our cohort. To reliably confirm or reject the significance of the observed impact of this rare coronary variant, a multicentre data analysis is required.
More Related Videos
08:42Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
08:13In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Related Concept Videos
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:26Coronary Artery Disease II: Pathophysiology