Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T02:52:38.805Z Has data issue: false hasContentIssue false
  • English
  • Français

Chronological changes in stenosis of translocated coronary arteries on angiography after the arterial switch operation in children with transposition of the great arteries: comparison of myocardial scintigraphy and angiographic findings

Published online by Cambridge University Press:  21 May 2015

Hisashi Sugiyama ,
Etsuko Tsuda ,
Hideo Ohuchi ,
Osamu Yamada  and
Isao Shiraishi
Hisashi Sugiyama*
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Etsuko Tsuda
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Hideo Ohuchi
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Osamu Yamada
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Isao Shiraishi
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
*
Correspondence to: H. Sugiyama, MD, Department of Pediatric Cardiology, Heart Institute, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo 162-8666, Japan. Tel: +8 133 353 8111; Fax: +8 133 356 0441; E-mail: psugiyama@hij.twmu.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The peri-operative mortality of the arterial switch operation in neonates with transposition of the great arteries is considerably low; however, long-term outcomes of translocated coronary arteries still remain one of the most crucial issues.

Methods and results

A total of 110 neonates with transposition of the great arteries after arterial switch operation were evaluated; three (2.7%) late deaths occurred. The remaining 107 patients except for one underwent follow-up angiography. Angiography showed coronary artery stenosis in nine (8.4%), with right coronary artery lesions in two and left main trunk lesions in seven. In two patients, right coronary artery stenosis regressed during follow-up. In left main trunk lesions, the severity of stenosis improved in four, did not change in one, and progressed to total occlusion in two patients. In children with coronary artery stenosis, myocardial scintigraphy showed perfusion defects in five out of six (83%) with left main trunk with ⩾75% stenosis and in four out of four with left main trunk stenosis ⩾90%. In contrast, patients whose coronary artery stenosis disappeared during follow-up had no perfusion defects on scintigraphy.

Conclusions

Regression of ostial stenosis of the transplanted coronary artery on angiogram was observed. The stenosis regressed over time in six patients; two coronary arteries with 99% stenosis and delayed angiographic enhancement of the distal coronary artery resulted in total occlusion within 1 year after the arterial switch operation. Combination of angiography and myocardial scintigraphy could be useful to differentiate deceptive stenosis from progressive stenosis.

Keywords

Transposition of the great arteriesarterial switch operationcoronary artery stenosismyocardial scintigraphy
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 4 , April 2016 , pp. 638 - 643
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Losay, J, Touchot, A, Serraf, A, et al. Late outcome after arterial switch operation for transposition of the great arteries. Circulation 2001; 104: I121–I126.Google Scholar
2. Prandstetter, C, Hofer, A, Lechner, E, et al. Early and mid-term outcome of the arterial switch operation in 114 consecutive patients: a single centre experience. Clin Res Cardiol 2007; 96: 723–729.Google Scholar
3. von Bernuth, G. 25 years after the first arterial switch procedure: mid-term results. Thorac Cardiovasc Surg 2000; 48: 228–232.Google Scholar
4. Williams, WG, McCrindle, BW, Ashburn, DA, et al. Outcomes of 829 neonates with complete transposition of the great arteries 12–17 years after repair. Congenital Heart Surgeon’s Society. Eur J Cardio Thorac Surg 2003; 24: 1–9.Google Scholar
5. Villafane, J, Lantin-Hermoso, MR, Bhatt, AB, et al. D-transposition of the great arteries: the current era of the arterial switch operation. J Am Coll Cardiol 2014; 64: 498–511.Google Scholar
6. Khairy, P, Clair, M, Fernandes, SM, et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation 2013; 127: 331–339.Google Scholar
7. Raisky, O, Bergoend, E, Agnoletti, G, et al. Late coronary artery lesions after neonatal arterial switch operation: results of surgical coronary revascularization. Eur J Cardiothorac Surg 2007; 31: 894–898.Google Scholar
8. Legendre, A, Losay, J, Touchot-Kone, A, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation 2003; 108 (Suppl 1): II186–II190.Google Scholar
9. Thrupp, SF, Gentles, TL, Kerr, AR, et al. Arterial switch operation: early and late outcome for intramural coronary arteries. Ann Thorac Surg 2012; 94: 2084–2090.CrossRefGoogle ScholarPubMed
10. Chen, JW, Chen, YS, Chang, CI, et al. Risk stratification and outcome of cardiac surgery for patients with body weight <2,500 g in an Asian Center. Circ J 2014; 78: 393–398.Google Scholar
11. Tsuda, E, Imakita, M, Yagihara, T, et al. Late death after arterial switch operation for transposition of the great arteries. Am Heart J 1992; 124: 1551–1557.Google Scholar
12. Haas, F, Wottke, M, Poppert, H, et al. Long-term survival and functional follow-up in patients after the arterial switch operation. Ann Thorac Surg 1999; 68: 1692–1697.Google Scholar
13. Tanel, RE, Wernovsky, G, Landzberg, MJ, et al. Coronary artery abnormalities detected at cardiac catheterization following the arterial switch operation for transposition of the great arteries. Am J Cardiol 1995; 76: 153–157.Google Scholar
14. Pasquali, SK, Hasselblad, V, Li, JS, et al. Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation 2002; 106: 2575–2580.Google Scholar
15. Ou, P, Khraiche, D, Celermajer, DS, et al. Mechanisms of coronary complications after the arterial switch for transposition of the great arteries. J Thorac Cardiovasc Surg 2013; 145: 1263–1269.Google Scholar
16. Veltman, CE, Beeres, SL, Kalkman, DN, et al. Variation in coronary anatomy in adult patients late after arterial switch operation: a computed tomography coronary angiography study. Ann Thorac Surg 2013; 96: 1390–1397.Google Scholar
17. Bartoloni, G, Bianca, S, Patanè, L, et al. Pathology of coronary narrowing after arterial switch operation: autopsy findings in two patients who died within 3 months of surgical treatment and review of the literature. Cardiovasc Pathol 2006; 15: 49–54.Google Scholar
18. El-Segaier, M, Lundin, A, Hochbergs, P, et al. Late coronary complications after arterial switch operation and their treatment. Catheter Cardiovasc Interv 2010; 1: 1027–1032.Google Scholar
19. Bonnet, D, Bonhoeffer, P, Piechaud, JF, et al. Long-term fate of the coronary arteries after the arterial switch operation in newborns with transposition of the great arteries. Heart 1996; 76: 274–279.Google Scholar
20. Aburawi, EH, Carlsson, M, Berg, A. Coronary artery stenosis in asymptomatic child after arterial switch operation: detection by transthoracic colour-flow Doppler echocardiography. Acta Paediatr 2008; 97: 376–378.Google Scholar
21. Manso, B, Castellote, A, Dos, L, et al. Myocardial perfusion magnetic resonance imaging for detecting coronary function anomalies in asymptomatic paediatric patients with a previous arterial switch operation for the transposition of great arteries. Cardiol Young 2010; 20: 410–417.Google Scholar
22. Hayes, AM, Baker, EJ, Kakadeker, A, et al. Influence of anatomic correction for transposition of the great arteries on myocardial perfusion: radionuclide imaging with technetium-99 m 2-methoxy isobutyl isonitrile. J Am Coll Cardiol 1994; 24: 769–777.Google Scholar
23. Weindling, SN, Wernovsky, G, Colan, SD, et al. Myocardial perfusion, function and exercise tolerance after the arterial switch operation. J Am Coll Cardiol 1994; 23: 424–433.Google Scholar
24. Kuehn, A, Vogt, M, Schwaiger, M, et al. Ventricular sympathetic innervation in patients with transposition of the great arteries after arterial switch operation and Rastelli procedure. Circ J 2014; 78: 1717–1722.Google Scholar