Coronary events and anatomy after arterial switch operation for transposition of the great arteries: detection by 16-row multislice computed tomography angiography in pediatric patients.
The purpose of this study was to evaluate the feasibility of multislice computed tomographic (MSCT) angiography as a noninvasive method for detecting ostial, proximal, and middle segment coronary stenosis or occlusion and anatomy in patients with transposition of the great arteries who had undergone arterial switch operation (ASO). Sixteen-detector-row MSCT angiography was performed in 16 patients treated with ASO for transposition of the great arteries. The median age was 10.3 years (range, 6.2-16.3 years). Sixteen-detector-row MSCT angiography was performed in 16 patients who had undergone ASO. CT imaging was performed in the craniocaudal direction from 2 cm above the carina up to the heart basis. Noninvasive assessment of coronary artery stenosis and anatomy were investigated by MSCT angiography. Two patients were excluded from the study because of artifacts. Of 14 evaluated patients, 1 patient had ostial stenosis (7.1%). A coronary artery anatomy variant was present in six patients: left main artery (LMA) and right coronary artery (RCA) originating from the right sinus as a single orifice (n = 2); left circumflex artery (LCX) originating from the RCA (n = 1); LMA and RCA, after branching to the LCX, originating separately from the right sinus (n = 1); and LMA (n = 1) and left anterior descending artery (LADA; n = 1) originating directly from the right sinus. Intramural bridging in the LAD (n = 2) was detected. Five patients were normal. In conclusion, MSCT angiography, as a noninvasive, feasible technique for assessing coronary stenosis or occlusion and anatomy, can be used in the follow-up of patients who have undergone ASO.
Oztunç
Funda
F
Department of Pediatrics, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey. foztunc@yahoo.com
Bariş
Safa
S
Adaletli
Ibrahim
I
Onol
Nurper Onder
NO
Olgun
Deniz Cebi
DC
Güzeltaş
Alper
A
Ozyilmaz
Isa
I
Ozdil
Mine
M
Kurugoğlu
Sebuh
S
Eroğlu
Ayşe Güler
AG
D000293:Adolescent; D002648:Child; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D003330:Coronary Vessel Anomalies / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014188:Transposition of Great Vessels / Q000601:surgery*; D016896:Treatment Outcome
D003287:Contrast Media