Unusual presentation of myocardial ischemia after arterial switch operation.
Ischemic changes and acute or subacute cardiac failure after arterial switch operation generally results from imperfect transfer of coronary arteries to the neoaorta. Peroperative and early postoperative myocardial ischemia is the main cause of death in these patients. We present an unusual cause of myocardial ischemia and cardiac failure after arterial switch: a congenital coronary artery fistula between the circumflex artery and the right ventricle. The symptoms imitate coronary translocation failure. In differential diagnosis of the coronary perfusion problems encountered after the arterial switch operation, coronary artery fistula should not be forgotten, although it is rare.
Cetin
Gürkan
G
Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey. gurkan@istanbul.edu.tr
Saltik
Levent
L
Ozkara
Ahmet
A
Babaoğlu
Kadir
K
D001164:Arteriovenous Fistula / Q000150:complications / Q000000981:diagnostic imaging; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006352:Heart Ventricles / Q000002:abnormalities; D006801:Humans; D007231:Infant, Newborn; D017202:Myocardial Ischemia / Q000209:etiology*; D011183:Postoperative Complications; D011859:Radiography; D014188:Transposition of Great Vessels / Q000601:surgery*