Skip to main content

Coronary Events and Anatomy After Arterial Switch Operation for Transposition of the Great Arteries: Detection by 16-Row Multislice Computed Tomography Angiography in Pediatric Patients

CardioVascular and Interventional Radiology volume 32, pages 206–212 (2009)Cite this article

Abstract

The purpose of this study was to evaluate the feasibility of multislice computed tomographic (MSCT) angiography as a noninvasive method for detecting ostial, proximal, and middle segment coronary stenosis or occlusion and anatomy in patients with transposition of the great arteries who had undergone arterial switch operation (ASO). Sixteen-detector-row MSCT angiography was performed in 16 patients treated with ASO for transposition of the great arteries. The median age was 10.3 years (range, 6.2–16.3 years). Sixteen-detector-row MSCT angiography was performed in 16 patients who had undergone ASO. CT imaging was performed in the craniocaudal direction from 2 cm above the carina up to the heart basis. Noninvasive assessment of coronary artery stenosis and anatomy were investigated by MSCT angiography. Two patients were excluded from the study because of artifacts. Of 14 evaluated patients, 1 patient had ostial stenosis (7.1%). A coronary artery anatomy variant was present in six patients: left main artery (LMA) and right coronary artery (RCA) originating from the right sinus as a single orifice (n = 2); left circumflex artery (LCX) originating from the RCA (n = 1); LMA and RCA, after branching to the LCX, originating separately from the right sinus (n = 1); and LMA (n = 1) and left anterior descending artery (LADA; n = 1) originating directly from the right sinus. Intramural bridging in the LAD (n = 2) was detected. Five patients were normal. In conclusion, MSCT angiography, as a noninvasive, feasible technique for assessing coronary stenosis or occlusion and anatomy, can be used in the follow-up of patients who have undergone ASO.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. Jatene AD, Fontes VF, Paulista PP et al (1975) Successful anatomic correction of transposition of the great vessels. A preliminary report. Arq Bras Cardiol 28:461–461

    PubMed  CAS  Google Scholar 

  2. Lecompte Y, Zannini L, Hazan E et al (1981) Anatomic correction of transposition of the great arteries. New technique without use of a prosthetic conduit. J Thorac Cardiovasc Surg 82:629–631

    PubMed  CAS  Google Scholar 

  3. Legendre A, Losay J, Touchot-Kone A et al (2003) Coronary events after arterial switch operation for transposition of the great arteries. Circulation 108(Suppl 1):II186–II190

    PubMed  Google Scholar 

  4. Losay J, Touchot A, Serraf A et al (2001) Late outcome after arterial switch operation for transposition of the great arteries. Circulation 104(Suppl 1):I121–I126

    PubMed  CAS  Google Scholar 

  5. Leschka S, Wildermuth S, Boehm T et al (2006) Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology 241:378–385

    Article  PubMed  Google Scholar 

  6. Ropers D, Baum U, Pohle K et al (2003) Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation 107:664–666

    Article  PubMed  Google Scholar 

  7. Ou P, Mousseaux E, Azarine A et al (2006) Detection of coronary complications after the arterial switch operation for transposition of the great arteries: first experience with multislice computed tomography in children. J Thorac Cardiovasc Surg 131:639–643

    Article  PubMed  Google Scholar 

  8. Pasquali SK, Hasselblad V, Li JS et al (2002) Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation 106:2575–2580

    Article  PubMed  Google Scholar 

  9. Kirklin JW, Black Stone EII, Tchervenkov CI et al (1992) Clinical outcomes after the arterial switch operation for transposition: patients, support, procedural and institutional risk factors. Circulation 86:1501–1515

    PubMed  CAS  Google Scholar 

  10. Blume ED, Altmann K, Mayer JE et al (1999) Evolution of risk factors influencing early mortality of the arterial switch operation. J Am Coll Cardiol 33:1702–1709

    Article  PubMed  CAS  Google Scholar 

  11. Oskarsson G, Pesonen E, Munkhammar P et al (2002) Normal coronary flow reserve after arterial switch operation for transposition of the great arteries: an intracoronary Doppler guidewire study. Circulation 106:1696–1702

    Article  PubMed  Google Scholar 

  12. Bonnet D, Bonhoeffer P, Piechaud JF et al (1996) Long-term fate of the coronary arteries after the arterial switch operation in newborns with transposition of the great arteries. Heart 76:274–279

    Article  PubMed  CAS  Google Scholar 

  13. Bonhoeffer P, Bonnet D, Piechaud JF et al (1997) Coronary artery obstruction after the arterial switch operation for transposition of the great arteries in newborns. J Am Coll Cardiol 29:202–206

    Article  PubMed  CAS  Google Scholar 

  14. Bartoloni G, Bianca S, Patane L et al (2006) 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 15:49–54

    Article  PubMed  Google Scholar 

  15. Raisky O, Bergoend E, Agnoletti G et al (2007) Late coronary artery lesions after neonatal arterial switch operation: results of surgical coronary revascularization. Eur J Cardiothorac Surg 31:894–898

    Article  PubMed  Google Scholar 

  16. Leschka S, Alkadhi H, Plass A et al (2005) Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 26:1482–1487

    Article  PubMed  Google Scholar 

  17. Achenbach S, Giesler T, Ropers D et al (2001) Detection of coronary artery stenosis by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation 103:2535–2538

    PubMed  CAS  Google Scholar 

  18. Vanhoenacker PK, Heijenbrok-Kal MH, Van Heste R et al (2007) Diagnostic performance of multidetector CT angiography for assessment of coronary artery disease: meta-analysis. Radiology 244:419–428

    Article  PubMed  Google Scholar 

  19. Hausleiter J, Meyer T, Hadamitzky M et al (2006) Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation 113:1305–1310

    Article  PubMed  Google Scholar 

  20. Jakobs TF, Becker CR, Ohnesorge B et al (2002) Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol 12:1081–1086

    Article  PubMed  Google Scholar 

  21. Hoffmann MH, Shi H, Schmitz BL et al (2005) Noninvasive coronary angiography with multislice computed tomography. JAMA 293:2471–2478

    Article  PubMed  CAS  Google Scholar 

  22. Taylor AM, Dymarkowski S, Hamaekers P et al (2005) MR coronary angiography and late-enhancement myocardial MR in children who underwent arterial switch surgery for transposition of great arteries. Radiology 234:542–547

    Article  PubMed  Google Scholar 

  23. Rickers C, Sasse K, Buchert R et al (2000) Myocardial viability assessed by positron emission tomography in infants and children after the arterial switch operation and suspected infarction. J Am Coll Cardiol 36:1676–1683

    Article  PubMed  CAS  Google Scholar 

  24. Weindling SN, Wernovsky G, Colan SD et al (1994) Myocardial perfusion, function and exercise tolerance after the arterial switch operation. J Am Coll Cardiol 23:424–433

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey

    Funda Öztunç, Safa Barış, Alper Güzeltaş, İsa Özyilmaz, Mine Özdil & Ayşe Güler Eroğlu

  2. Department of Radiology, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey

    İbrahim Adaletli, Nurper Önder Önol, Deniz Cebi Olgun & Sebuh Kurugoğlu

Authors
  1. Funda Öztunç
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Safa Barış
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. İbrahim Adaletli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nurper Önder Önol
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Deniz Cebi Olgun
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alper Güzeltaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. İsa Özyilmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mine Özdil
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sebuh Kurugoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ayşe Güler Eroğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Safa Barış.

Additional information

This study was accepted as a poster presentation at ESPR 2008.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Öztunç, F., Barış, S., Adaletli, İ. et al. Coronary Events and Anatomy After Arterial Switch Operation for Transposition of the Great Arteries: Detection by 16-Row Multislice Computed Tomography Angiography in Pediatric Patients. Cardiovasc Intervent Radiol 32, 206–212 (2009). https://doi.org/10.1007/s00270-008-9432-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-008-9432-3

Keywords

  • Multislice computed tomographic angiography
  • Coronary events
  • Arterial switch operation
  • Transposition of great arteries