Rev Port Cardiol. 2025 Dec;44(12):721-726. doi: 10.1016/j.repc.2025.06.007. Epub 2025 Oct 25.
ABSTRACT
BACKGROUND AND PURPOSE: Arterial switch operation (ASO) is currently the standard surgical repair for D-transposition of great arteries (D-TGA). As the procedure implies reimplantation of the coronary arteries into the neo-aortic root, long-term coronary complications are possible and potentially dangerous. However, routine coronary evaluation after ASO remains controversial. The purpose of this study is to perform a descriptive analysis of coronary computed tomography angiography (CCTA) findings in adolescent and young adults with D-TGA after ASO.
METHODS: We performed a retrospective single center study that included adolescent and young adults with D-TGA submitted to ASO who underwent CCTA. Demographic, clinical and imaging data were collected.
RESULTS: We identified 57 patients with D-TGA submitted to ASO. Of these, 39 performed a CCTA. Mean age of patients was 19.6 (±4.2) years; 54% were male; 32% had complex D-TGA. In 35 patients (90%), CCTA was part of routine screening. In four (10%) patients CCTA was done due to symptoms or an abnormal non-invasive test suggestive of myocardial ischemia. Eighteen (46%) patients had coronary anomalies: five (13%) had an acute angulation at the coronary origin; 13 (33%) patients had anomalous origin of the coronary arteries. Interarterial course was described in two (5%) patients and retroaortic course reported in eight (21%) cases.
CONCLUSIONS: Adolescent and young adults with D-TGA submitted to ASO have a high incidence of coronary anomalies. Routine screening with CCTA may be justified to identify patients who may be at higher risk of coronary events.
PMID:42844832 | DOI:10.1016/j.repc.2025.06.007