[Influence of coronary anatomy on the anatomic repair of transposition of great arteries].
BACKGROUND
The anatomic diversity of the coronary artery and the alignment of the aortic and pulmonary valves have special importance on the surgical anatomic correction of the transposition of the great arteries and double outlet of the right ventricle, because of their repercussions on surgical technique and the effect on the operative results.


OBJECTIVE
To determine the coronary artery pattern; the aortic and pulmonary valve alignment, and their effects on the surgical results in 57 patients submitted to anatomic correction in our hospital.


METHODS
We used the Yacoub and Radley-Smith patterns in order to classify the different coronary distributions. The relation between the coronary pattern and degree of alignment with surgical difficulty and the mortality rate was examined. The coronary pattern established by echocardiography was compared with the surgical findings in the last 16 patients.


RESULTS
31 patients belonged to group A, 3 to B, 2 to C, 19 to D and 2 to E. There was no difference in the extracorporeal circulation time among the groups, although the difficulty in the coronary transfer was not the same among them. Type E mortality rate was 50%, type B 33%, and type D 5.2%. There were no deaths in the other groups. Malalignment was found in the three patients who died. The coronary pattern found by echocardiography was confirmed in 13 patients whose images were quite clear.


CONCLUSIONS
Coronary pattern and the malignment affect both surgical difficulty and mortality rate of patients undergoing anatomic correction. Bidimensional-echocardiography is useful to demonstrate the different coronary patterns in most cases.
Girona Comas
J
J
Unidad de Cardiología Pediátrica, Hospital Universitario Materno-Infantil Vall d'Hebron, Barcelona.
Brotons
D A
DA
Sánchez López
C
C
Serrano Durán
M
M
Casaldàliga Ferrer
J
J
Murtra Ferrer
M
M
D000015:Abnormalities, Multiple; D003330:Coronary Vessel Anomalies; D003331:Coronary Vessels / Q000033:anatomy & histology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D014188:Transposition of Great Vessels / Q000601:surgery*
Influencia de la anatomía coronaria en la corrección anatómica de la transposición de grandes arterias.