title: Late results after PTCA for coronary stenosis after the arterial switch procedure for transposition of the great arteries.
abstract: BACKGROUND
  The arterial switch operation has become the surgical approach of choice for d-transposition of the great arteries, but there is an increased awareness of adverse sequelae in some survivors. Long-term patency and normal function of the translocated coronary arteries must be achieved. It is reported that dependent of the prior coronary status, 3% to 11% of all survivors have proximal coronary stenosis or complete occlusion develop after arterial switch operations. However, treatment of these stenoses is still a matter of debate. Late results after percutaneous transluminal coronary angioplasty (PTCA) for coronary stenosis after the arterial switch operation for d-transposition of the great arteries are reported.
  
  
  METHODS
  Seven children after arterial switch operation for d-transposition of the great arteries who had subsequently undergone PTCA for coronary stenosis were angiographically re-evaluated 3 to 15 months after the initial PTCA and again after 3 to 5 years.
  
  
  RESULTS
  All children survived the initial PTCA procedure. There were no late deaths. The degree of stenosis before PTCA ranged from 74% to 97%; immediately after PTCA from 5% to 10%; at 3 to 15 months after PTCA from zero to 6%; and at 3 to 5 years after PTCA from zero to 3%. Three to 5 years after PTCA all children showed normal development of the treated coronary artery.
  
  
  CONCLUSIONS
  Primary PTCA of stenotic proximal coronary arteries after the arterial switch procedure for d-transposition of the great arteries seems to be an effective treatment with excellent long-term results.
authors.affiliation: Division of Pediatric Cardiology, Hospital for Sick Children, Mainz, Germany. kampmann@mail.uni-mainz.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Kampmann
authors.forename: Wlodzimierz
authors.initials: W
authors.lastname: Kuroczynski
authors.forename: Hubert
authors.initials: H
authors.lastname: Trübel
authors.forename: Markus
authors.initials: M
authors.lastname: Knuf
authors.forename: Martin
authors.initials: M
authors.lastname: Schneider
authors.forename: Markus K
authors.initials: MK
authors.lastname: Heinemann
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D023921:Coronary Stenosis / Q000145:classification / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D011184:Postoperative Period; D014188:Transposition of Great Vessels / Q000601:surgery*