Coronary arteries in transposition of the great arteries

Angelini, Paolo; Cruz, María V. de la; Valencia, Adriana; Sánchez‐Gómez, Concepción; Kearney, Debra L.; Sadowinski, Stanislaw; Real, Gilda R.

doi:10.1016/0002-9149(94)90855-9

Cited by 16 publications

(6 citation statements)

References 21 publications

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“…Surgical correction might still have been difficult. Strongly related to the intramural course itself were the features of tangential origin 10 and the origin relative to the sinutubular junction. High take-off also produces tangential attachment to the arterial wall, and this feature can lead to accidental injury when the aorta is opened.…”

Section: Discussionmentioning

confidence: 98%

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Anatomic Variability in Coronary Arterial Distribution With Regard to the Arterial Switch Procedure

et al. 2002

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Background-We investigated the coronary arterial origins and course and the position of the great arteries in hearts with discordant ventriculoarterial connections. At the same time, we sought to evaluate the practicality of alphanumeric classifications in accounting for surgically relevant features of the coronary arteries. Methods and Results-We studied 200 postmortem hearts, noting the patterns of coronary arterial branching, the vertical and horizontal location of the arterial orifices within the aortic sinuses, the course of the proximal coronary arteries in relation to the aortic wall, and the relations of the great arteries and their respective commissures. All hearts examined had concordant atrioventricular and discordant ventriculoarterial connections. We found 7 of the 8 predicted patterns for sinusal origin of the 3 major coronary arteries and identified 5 different positions of the arterial trunks relative to each other. A correlation was found between less frequent relationships of the arterial trunks and unusual patterns of coronary arterial branching, as well as with mismatch between the valvar commissures. Conclusions-The surgically relevant features of the coronary arteries in hearts with discordant ventriculoarterial connections are best described rather than classified. Correlations exist between certain, less frequent relations of the great arteries and unusual patterns of branching of the coronary arteries. The presence of unusual great arterial positions should alert the surgeon to potentially complicated arrangements of the origin and distribution of the coronary arteries.

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Section: Discussionmentioning

confidence: 98%

“…We found orthogonal, tangential, and intramural arrangements. 10 We then examined the orientation of the sinuses of the aorta relative to those of the pulmonary trunk. In most cases, the commissures between the valvar leaflets faced each other at the sinutubular junctions.…”

Section: Methodsmentioning

confidence: 99%

Anatomic Variability in Coronary Arterial Distribution With Regard to the Arterial Switch Procedure

et al. 2002

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“…An intramural course (Figs. 13 and 14B) is constantly present for a segment ranging from 5 to 25 mm in length (and possibly even longer if the anomalous ostium is located high above the sinotubular junction, as it sometimes is, particularly in transposition of the great vessels [46]). This course, along with the related acute takeoff, implies a slit-like ostium (which, by itself, does not cause a fixed stenotic effect).…”

Section: Imaging Techniques For Evaluating Lesion Severity: Intravascmentioning

confidence: 97%

Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults

Angelini

Flamm

2007

Cathet Cardio Intervent

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112

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Of the different kinds of coronary anomalies observed in adults, anomalous origin of a coronary artery from the opposite sinus of Valsalva with an "interarterial" course (ACAOS) entails a high risk of clinical consequences related to the intramural course of the ectopic coronary artery. We review current imaging modalities for differentiating this condition from generally benign coronary anomalies and for quantifying the severity of individual cases. For identifying ACAOS, noninvasive modalities (echocardiography, computed tomographic angiography, and coronary magnetic resonance angiography) are preferred: the favored modalities are transthoracic echocardiography in children and multidetector computed tomography in adults. For evaluating the pathophysiologic mechanisms of ischemia in ACAOS and subclassifying the severity of individual forms, coronary intravascular ultrasonography provides enhanced temporal and spatial resolution. The critical quantifiable features of the coronary anatomy in ACAOS seem to be hypoplasia, lateral compression at the level of the intramural course, and possibly exercise-related further narrowing of the proximal ectopic segment. Definitive guidelines are being developed for the optimal workup and treatment of ACAOS.

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“…Among 133 TGA cases, Angelini et al (8) found three with three coronary ostia, and in only one of these three cases was there side-by-side location of the great arteries (8).…”

Section: Resultsmentioning

confidence: 99%

Anatomic Correction in Transposition of the Great Arteries with Unusual Coronary Pattern and Side-by-Side Location

As²,

Sezgin³

et al. 1998

Scandinavian Cardiovascular Journal

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Switch operation is the treatment of choice in infants with transposition of the great arteries. The anatomic correction restores the left ventricle to its normal systemic function. In complete transposition, however, the diverse spectrum of coronary pattern influences the surgical outcome. We describe a successful arterial switch operation without LeCompte manoeuvre in a neonate with unusual coronary artery anatomy and side-by-side great arteries.

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Coronary arteries in transposition of the great arteries

Cited by 16 publications

References 21 publications

Anatomic Variability in Coronary Arterial Distribution With Regard to the Arterial Switch Procedure

Anatomic Variability in Coronary Arterial Distribution With Regard to the Arterial Switch Procedure

Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults

Anatomic Correction in Transposition of the Great Arteries with Unusual Coronary Pattern and Side-by-Side Location

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