Left Main Coronary Artery Stenting in a Neonate After Arterial Switch Operation for Transposition of the Great Arteries

Abstract

Anatomical correction of transposition of the great arteries (TGA) with an intramural coronary artery is associated with high risk of coronary complications such as vessel injury and stenosis. Here, we report on a case of left main coronary artery stenting in a neonate with single coronary artery after repair for TGA.

Coronary Artery Anomalies in Patients With Transposition of the Great Arteries and Their Impact on Postoperative Outcomes

“…Intramural coronary artery courses, which are significantly associated with death in a large number of studies [10,12,13,16], are also associated with higher incidences of intramural arterial injury during transplantation or postoperative coronary artery stenosis [15]. This pattern was not significantly associated with any of the outcomes analyzed in our study.…”

“…These differences may be related to the accuracy of retrospective coronary anomaly detection as well as the selection of covariates and the description of surgical outcomes. These discrepancies may also be attributed to differences in the surgical techniques used at different centers and to differences in the experience levels of the surgeons performing the procedures, both of which are particularly important with respect to the success of coronary translocation [5,15].…”

Left main coronary artery stenting in a 3.6 kg infant after arterial switch operation for transposition of the great arteries

“…There are only a few case reports in the literature in infants less than 3 month of age, summarized in Table 1. [23] This case represents an unusual presentation of coronary artery stenosis post ASO. Even though flash pulmonary edema is a well-known manifestation of coronary stenosis in the adult population, it has not been described in the pediatric population.…”

Multimodality Imaging Guidelines of Patients with Transposition of the Great Arteries: A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography

“…If stenosis is diagnosed, there may be a role for CA stenting in this clinical setting. 207 After ASO, 20% to 30% of patients develop proximal branch pulmonary artery stenoses ( Figure 48). 54,55 Some of these patients Figure 47 Anteroposterior fluoroscopic image during a BAS in a neonate with TGA.…”

“…In the immediate postoperative period after an ASO, if an infant cannot be weaned from cardiopulmonary bypass, there is a role for angiography to determine patency of the proximal CAs. 207 In addition, new onset of ventricular arrhythmia warrants CA imaging to exclude ischemia. If stenosis is diagnosed, there may be a role for CA stenting in this clinical setting.…”