Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2010
Late coronary complications after arterial switch operation and their treatment.
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El-Segaier Milad, Lundin Anders, Hochbergs Peter, Jögi Peeter, Pesonen Erkki
Аннотация
OBJECTIVES: To report the late coronary complications and their treatment after arterial switch operation (ASO).
BACKGROUND: Asymptomatic patients after ASO may have coronary ostial stenosis or obstruction.
METHODS: Since 1980, 279 patients were operated with ASO. At the time of preparing this article, selective follow-up coronary angiograms were done on 81 patients.
RESULTS: Coronary stenosis was found in six patients. A 6-year-old patient with left coronary artery (LCA) ostial stenosis and a 9-year-old patient with conus branch occlusion had good collaterals without a need for further treatment. One patient with LCA obstruction, myocardial infarction, and left ventricular failure was operated with osteoplasty at age of 16 years. In three essentially asymptomatic patients, stenting of LCA ostium stenosis was done: in two of them with drug-eluting stents at 9 and 10 years of age and in one with bare-metal stent at 18 years of age. One of these patients was earlier treated with balloon dilatation at 5 years of age which caused intimal dissection.
CONCLUSIONS: Asymptomatic patients with an uneventful course after ASO may have coronary obstruction. This necessitates follow-up coronary evaluation in all patients. Stenting of the coronary arteries is an option for treatment.
BACKGROUND: Asymptomatic patients after ASO may have coronary ostial stenosis or obstruction.
METHODS: Since 1980, 279 patients were operated with ASO. At the time of preparing this article, selective follow-up coronary angiograms were done on 81 patients.
RESULTS: Coronary stenosis was found in six patients. A 6-year-old patient with left coronary artery (LCA) ostial stenosis and a 9-year-old patient with conus branch occlusion had good collaterals without a need for further treatment. One patient with LCA obstruction, myocardial infarction, and left ventricular failure was operated with osteoplasty at age of 16 years. In three essentially asymptomatic patients, stenting of LCA ostium stenosis was done: in two of them with drug-eluting stents at 9 and 10 years of age and in one with bare-metal stent at 18 years of age. One of these patients was earlier treated with balloon dilatation at 5 years of age which caused intimal dissection.
CONCLUSIONS: Asymptomatic patients with an uneventful course after ASO may have coronary obstruction. This necessitates follow-up coronary evaluation in all patients. Stenting of the coronary arteries is an option for treatment.
Предметные рубрики MeSH
AdolescentAngioplasty, Balloon, CoronaryAsymptomatic DiseasesCardiac Surgical ProceduresChildCollateral CirculationCoronary AngiographyCoronary CirculationCoronary OcclusionCoronary StenosisDrug-Eluting StentsEchocardiographyHumansPlatelet Aggregation InhibitorsProsthesis DesignReoperationRetrospective StudiesStentsSwedenTime FactorsTomography, Emission-Computed, Single-PhotonTransposition of Great VesselsTreatment Outcome