HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Asou, T. Articles by Mee, R. B. Search for Related Content PubMed PubMed Citation Articles by Asou, T. Articles by Mee, R. B.

The Annals of Thoracic Surgery, Vol 57, 461-465, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Arterial switch: translocation of the intramural coronary artery

T Asou, TR Karl, A Pawade and RB Mee
Victorian Cardiac Surgical Unit, Royal Children's Hospital, Melbourne, Australia.

Translocation of an intramural coronary artery is one of the most challenging problems in anatomic correction of transposition of the great arteries. Of 259 patients undergoing arterial switch procedure for transposition of the great arteries in our hospital, 12 (4.6%) were found to have intramural coronary arteries. The diagnosis was made intraoperatively in all patients. There were five different types of intramural coronary anatomy noted, with ostial stenosis present in half. The operative technique consisted of detachment of the posterior commissure of the aortic valve and unroofing of the intramural segment of the coronary artery by excision of a triangular portion of internal aortic wall. The coronary arteries were excised as a single disc, which was divided into two cuffs. The arterial switch was then performed in the usual fashion. The posterior commissure of the aortic valve was resuspended to the pericardial patch used to reconstruct the neopulmonary artery sinus. There were no operative or late deaths over a follow-up of 328 patient-months. Postoperatively, no patient showed ischemic changes on electrocardiogram or abnormal wall motion on echocardiogram. We believe that intramural coronary arteries can be managed satisfactorily with this technique, and that arterial switch will be possible in all cases.

This article has been cited by other articles:

				S. C. Sung, Y. H. Chang, H. D. Lee, S. Kim, J. S. Woo, and Y. S. Lee Arterial Switch Operation for Transposition of the Great Arteries With Coronary Arteries From a Single Aortic Sinus Ann. Thorac. Surg., August 1, 2005; 80(2): 636 - 641. [Abstract] [Full Text] [PDF]

				M. A. Padalino, R. G. Ohye, E. J. Devaney, and E. L. Bove Double Intramural Coronary Arteries in D-Transposition of the Great Arteries Ann. Thorac. Surg., December 1, 2004; 78(6): 2181 - 2183. [Abstract] [Full Text] [PDF]

				B. W. Duncan, N. C. Poirier, R. B. B. Mee, J. J. Drummond-Webb, A. Qureshi, C. I. Mesia, J. A. Graney, C. L. Malek, and L. A. Latson Selective timing for the arterial switch operation Ann. Thorac. Surg., May 1, 2004; 77(5): 1691 - 1696. [Abstract] [Full Text] [PDF]

				M. Yamagishi, K. Shuntoh, K. Fujiwara, T. Shinkawa, T. Miyazaki, and N. Kitamura "Bay window" technique for the arterial switch operation of the transposition of the great arteries with complex coronary arteries Ann. Thorac. Surg., June 1, 2003; 75(6): 1769 - 1773. [Abstract] [Full Text] [PDF]

				S. K. Gandhi, F. A. Pigula, and R. D. Siewers Intramural left coronary artery associated with right ventricular outflow tract obstruction J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 729 - 730. [Full Text] [PDF]

				H. Imura, P. Modi, A. Pawade, A. J. Parry, M.-S. Suleiman, G. D. Angelini, and M. Caputo Cardiac troponin I in neonates undergoing the arterial switch operation Ann. Thorac. Surg., December 1, 2002; 74(6): 1998 - 2002. [Abstract] [Full Text] [PDF]

				P. Massoudy, A. Baltalarli, M. R. de Leval, A. Cook, U. Neudorf, G. Derrick, K. P. McCarthy, and R. H. Anderson Anatomic Variability in Coronary Arterial Distribution With Regard to the Arterial Switch Procedure Circulation, October 8, 2002; 106(15): 1980 - 1984. [Abstract] [Full Text] [PDF]

				S. H. Daebritz, G. Nollert, J. S. Sachweh, W. Engelhardt, G. von Bernuth, and B. J. Messmer Anatomical risk factors for mortality and cardiac morbidity after arterial switch operation Ann. Thorac. Surg., June 1, 2000; 69(6): 1880 - 1886. [Abstract] [Full Text] [PDF]

				J Li, R M R Tulloh, A Cook, M Schneider, S Y Ho, and R H Anderson Coronary arterial origins in transposition of the great arteries: factors that affect outcome. A morphological and clinical study Heart, March 1, 2000; 83(3): 320 - 325. [Abstract] [Full Text]

				V. Shukla, R. M. Freedom, and M. D. Black Single coronary artery and complete transposition of the great arteries: a technical challenge resolved? Ann. Thorac. Surg., February 1, 2000; 69(2): 568 - 571. [Abstract] [Full Text] [PDF]

				J Li, N D Soukias, J S Carvalho, and S Y. Ho Coronary arterial anatomy in tetralogy of Fallot: morphological and clinical correlations Heart, August 1, 1998; 80(2): 174 - 183. [Abstract] [Full Text]

				H. Yaku, G. R. Nunn, and G. F. Sholler Internal Mammary Artery Grafting in a Neonate for Coronary Hypoperfusion After Arterial Switch Ann. Thorac. Surg., August 1, 1997; 64(2): 543 - 544. [Abstract] [Full Text]

				J. L. Myers Transposition of the Great Arteries Ann. Thorac. Surg., March 1, 1997; 63(3): 895 - 898. [Full Text]

				S. Shankar, N. Sreeram, W. J. Brawn, and B. Sethia Intraoperative Ultrasonographic Troubleshooting After the Arterial Switch Operation Ann. Thorac. Surg., February 1, 1997; 63(2): 445 - 448. [Abstract] [Full Text]

				K. S. Murthy and K. M. Cherian A NEW TECHNIQUE OF ARTERIAL SWITCH OPERATION WITH IN SITU CORONARY REALLOCATION FOR TRANSPOSITION OF GREAT ARTERIES J. Thorac. Cardiovasc. Surg., July 1, 1996; 112(1): 27 - 32. [Abstract] [Full Text]