Surgical treatment of infants with transposition of the great arteries and intramural coronary artery
- VernacularTitle:婴儿完全性大动脉转位合并冠状动脉壁内走行的外科治疗
- Author:
Yaojun DUN
1
;
Haining SUN
1
;
Jun YAN
1
;
Keming YANG
1
;
Zhongdong HUA
1
;
Qiang WANG
1
;
Shoujun LI
1
Author Information
1. Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, 100037, P. R. China
- Publication Type:Journal Article
- Keywords:
Transposition of the great arteries;
arterial switch operation;
intramural coronary artery;
coronary transfer;
surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(03):323-329
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the surgical experience of infants with transposition of the great arteries (TGA) and intramural coronary artery (IMCA) in our center, and analyze the early and mid-term outcomes. Methods We retrospectively analyzed the clinical data of 384 infants with TGA undergoing arterial switch operation (ASO) from June 2010 to December 2018 at Fuwai Hospital. According to operative records, 21 (5.5%) infants had IMCA, among whom 20 were males, with a median age of 33 (9-319) d. Coronary transfer using double coronary buttons with unroofed intramural course was performed in all 21 infants. Results There was no statistical difference in the early mortality after ASO between infants with IMCA and infants with normal coronary anatomy (9.5% vs. 3.0%, P=0.15). In the IMCA group, 2 dead patients presented inadequate coronary artery perfusion after first aortic unclamping. In addition, 1 patient underwent extracorporeal membrane pulmonary support for myocardial dysfunction. The follow-up was available for all 19 survivors, with an average follow-up time of 29.0-120.0 (74.8±27.3) months. During the follow-up, all patients had no obvious symptoms, death, reoperation, or coronary complications. One patient developed moderate pulmonary valve regurgitation and another patient developed distal stenosis of the right pulmonary artery. Conclusion For infants with TGA and IMCA, coronary transfer using double coronary buttons with unroofed intramural course is a safe and reliable technique, with satisfactory early and mid-term outcomes.
