Ann Thorac Surg 2005;80:1646
© 2005 The Society of Thoracic Surgeons
Original article: Cardiovascular
Invited commentary
Roger Mee, FRACS
Department of Pediatric & Congenital Heart Surgery, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195-5066
(Email: meer{at}ccf.org).
This is an important article [1]. Many centers have reported early or late stenoses of coronary arteries after the arterial switch operation for transposition of the vessels, both early and late. The varying incidences of coronary stenoses are probably related to the surgical techniques used. On many occasions the stenosis is asymptomatic and is discovered at re-catheterization for evolving problems in the right ventricular outflow tract and left ventricular outflow tract defined by follow-up echocardiography.
The collated experience from three hospitals over the short and intermediate term after balloon angioplasty of stenotic coronary arteries is very encouraging. They have shown that balloon dilatation for this condition in young children is feasible and fairly reproducible, and more importantly, over a period of 3 to 5 years, the dilated coronaries have remained widely patent. The authors have carefully described the technique they use and have really laid down a blueprint for the management of this particular problem after the arterial switch operation, which has been a concern to many centers. As yet, there cannot be full confidence that coronary stenosis after the arterial switch operation is lastingly corrected by balloon dilatation.
We would hope that this same group will review their 7 patients in a further 5 years and provide a follow-up communication to this journal. One would also hope that this particular article will stimulate the publishing of other articles describing the experiences from other centers for handling post-arterial switch coronary stenosis.
 |
References
|
|---|
- Kampmann C, Kuroczynski W, Trübel H, Knuf M, Schneider M, Heinemann MK. Late results after PTCA for coronary stenosis after the arterial switch procedure for transposition of the great arteries Ann Thorac Surg 2005;80:1641-1646.[Abstract/Free Full Text]
Top
References