Coronary anatomy in congenitally corrected transposition of the great arteries

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

“…Other possibilities include coronary perfusion mismatch, because the cardiac hypertrophy caused by the added pressure load on the morphological right ventricle may outstrip the coronary artery oxygen supply, which comes mainly from the right coronary artery. 598 A high incidence of myocardial perfusion defects with regional wall-motion abnormalities and impaired ventricular contractility has been reported. 599 Positron emission tomography studies of blood flow measurements have also suggested that coronary reserve is decreased in the absence of ischemic symptoms in patients with CCTGA.…”

Isolated Congenitally Corrected Transposition of the Great Arteries with Dextroversion Discovered Incidentally in a Patient with Cocaine-Induced Acute Myocardial Infarction

“…Dextrocardia with situs solitus (normally oriented viscera) and no other cardiac anomalies is rare, with an incidence of 1 live birth in 30,000 ( 3 ). Th e approach to evaluating a patient with dextrocardia, once the condition has been identifi ed, should include identifi cation of visceral situs, atrioventricular concordance, ventricular morphology and situs, relation of the great arteries, and fi nally associated abnormalities ( 4 ). Imaging modalities such as echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and invasive coronary angiography can all be used in conjunction to allow for accurate diagnosis.…”

“…Coronary anatomy, in particular, is variable. In up to 50% of patients, there may be associated coronary anomalies ( 4 ). Patients who present with coronary atherosclerosis or acute coronary syndromes are uncommon, as these patients usually present with systemic ventricular failure early in life.…”

A Rare Case of Congenitally Corrected Transposition of Great Arteries with Complete Heart Block

“…11 Previous studies have suggested a consistently inverted coronary arterial pattern in patient with CCTGA and, rarely, a coronary ostium or artery. 6 An anatomical systemic ventricle ,which makes a venous ventricle in a patient with CCTGA , presents challenges that are unique during PPM or ICD lead placement. Unlike a true RV, which is full of trabeculi where the PPM or ICD lead can be positioned, the anatomical systemic ventricle is devoid of these structures, thus making it harder to obtain a stable lead position and possibly increasing the risk of lead displacement.…”