title: Unusual presentation of myocardial ischemia after arterial switch operation.
abstract: 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.
authors.affiliation: Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey. gurkan@istanbul.edu.tr
authors.forename: Gürkan
authors.initials: G
authors.lastname: Cetin
authors.forename: Levent
authors.initials: L
authors.lastname: Saltik
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozkara
authors.forename: Kadir
authors.initials: K
authors.lastname: Babaoğlu
mesh_terms: 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*