Internal mammary artery bypass graft for impaired coronary perfusion after neonatal arterial switch operation.
Myocardial ischaemia caused by perfusion impairment of translocated coronary arteries is the major cause of perioperative mortality after neonatal arterial switch operation for transposition of the great arteries. We report the successful use of the right internal mammary artery as a bypass graft to a dominant right coronary artery to treat insufficient perfusion of this artery in a newborn. Eight months later, coronary angiography showed a full blood supply of the right coronary artery across the internal mammary anastomosis. After a follow-up period of more than 30 months, somatic development, electrocardiogram and echocardiographically determined contractility of both ventricles are practically normal indicating regular function of the bypass graft.
Grabitz
R G
RG
Department of Pediatric Cardiology, RWTH Aachen, FRG.
Messmer
B J
BJ
Seghaye
M C
MC
Engelhardt
W
W
Mühler
E
E
von Bernuth
G
G
D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D009204:Myocardial Revascularization / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging