Presentation is loading. Please wait.

Presentation is loading. Please wait.

Mechanisms of coronary complications after the arterial switch for transposition of the great arteries  Phalla Ou, MD, PhD, Diala Khraiche, MD, David.

Published byBertram Perry Modified over 5 years ago

Similar presentations

Presentation on theme: "Mechanisms of coronary complications after the arterial switch for transposition of the great arteries  Phalla Ou, MD, PhD, Diala Khraiche, MD, David."— Presentation transcript:

1 Mechanisms of coronary complications after the arterial switch for transposition of the great arteries  Phalla Ou, MD, PhD, Diala Khraiche, MD, David S. Celermajer, PhD, FRACP, DSc, FAA, Gabriella Agnoletti, MD, PhD, Kim-Hanh Le Quan Sang, MD, Jean Christophe Thalabard, MD, PhD, Mathieu Quintin, MS, Olivier Raisky, MD, PhD, Pascal Vouhe, MD, PhD, Daniel Sidi, MD, PhD, Damien Bonnet, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 145, Issue 5, Pages (May 2013) DOI: /j.jtcvs Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Determination of the coronary angles. The commonest positioning of the greats arteries and the coronaries after ASO are representing here. The coronary angles were determined as follows: (1) The aortopulmonary centerline that passes through the center of both the aorta and the pulmonary artery was drawn; (2) the perpendicular of the aortopulmonary centerline that passes through the center of the aorta is the reference line (0°); (3) the angle between the coronary ostia (red cross, left ostium; green cross, right ostium) and the reference line correspond to the coronary angle. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Significant stenosis of the ostium of the left coronary artery by anterior compression by the pulmonary artery. The reimplantation is too anterior, as confirmed by the left coronary angle (green curve) almost equal to 90°, corresponding to a reimplantation at 12 o' clock. PA, Pulmonary artery; Ao, aorta. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Tight stenosis of the LAD in the Yacoub type D. The reimplantation of the LAD (black arrow on the left panel) is to anterior as indicated by the left coronary angle almost equal to 90° (green curve on the left panel), and also too high above the left coronary sinus, as identified by the short coronary–pulmonary bifurcation distance (red arrow on the right panel) equal to 5 mm. PA, Pulmonary artery; Ao, aorta; LAD, left anterior descending artery. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Mechanism of lesion of the circumflex artery in Yacoub type D. The reimplantation of the right ostium was too far under the right sinus, as evidenced by the long coronary–pulmonary artery distance (red arrow on the right panel). Thus, the course of the circumflex toward the left atrioventricular groove is increased, causing a stretching of the coronary artery (black arrow on the left panel). Ao, Aorta; LV, left ventricle. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

6 Figure 5 Lesion of the right coronary artery. The reimplantation of the right sinus is too high above the right sinus, as evidenced by the short coronary–pulmonary artery bifurcation distance (red arrow). The right ostium was then compressed by the pulmonary artery. This patient had a long “olasty” of the ostium and proximal segment of the right coronary artery using saphenous vein. See the difference in caliber between the saphenous vein in the proximal segment and the native distal segment, which is thinner. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

7 Figure 6 Delayed on first-pass perfusion (black arrow, and see Video 1). Magnetic resonance imaging sequence involving the anteroseptobasal segment in a patient with a tight stenosis in the left anterior descending artery (Yacoub type D) owing to a compression by the pulmonary artery. Ischemia was also confirmed on myocardial scintigraphy. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Download ppt "Mechanisms of coronary complications after the arterial switch for transposition of the great arteries  Phalla Ou, MD, PhD, Diala Khraiche, MD, David."

Similar presentations

Manuel J. Antunes, MD, PhD, DSc 

Manuel J. Antunes, MD, PhD, DSc 
Circumflex artery injury during mitral valve repair: Not well known, perhaps not so infrequent—lessons learned from a 6-case experience  Gonçalo F. Coutinho,

Circumflex artery injury during mitral valve repair: Not well known, perhaps not so infrequent—lessons learned from a 6-case experience  Gonçalo F. Coutinho,
Reduction of systolic and diastolic dysfunction by retrograde coronary sinus perfusion during off-pump coronary surgery  Manuel Castellá, MD, Gerald D.

Reduction of systolic and diastolic dysfunction by retrograde coronary sinus perfusion during off-pump coronary surgery  Manuel Castellá, MD, Gerald D.
Anomalous left coronary artery origin from the opposite sinus of Valsalva: Evidence of intermittent ischemia  Julie Brothers, MD, Chris Carter, MD, Michael.

Anomalous left coronary artery origin from the opposite sinus of Valsalva: Evidence of intermittent ischemia  Julie Brothers, MD, Chris Carter, MD, Michael.
Translocation of a single coronary artery from the nonfacing sinus in the arterial switch operation: Long-term patency of the interposition graft  Igor.

Translocation of a single coronary artery from the nonfacing sinus in the arterial switch operation: Long-term patency of the interposition graft  Igor.
Myocardial bridging over the left anterior descending: Myotomy, bypass, or both?  Chigozirim N. Ekeke, BS, Stephen Noble, MD, Ernest Mazzaferri, MD, Juan.

Myocardial bridging over the left anterior descending: Myotomy, bypass, or both?  Chigozirim N. Ekeke, BS, Stephen Noble, MD, Ernest Mazzaferri, MD, Juan.
Long-term (5- to 20-year) patency of the radial artery for coronary bypass grafting  Paul Achouh, MD, Redha Boutekadjirt, MD, Daniel Toledano, MD, Nadjib.

Long-term (5- to 20-year) patency of the radial artery for coronary bypass grafting  Paul Achouh, MD, Redha Boutekadjirt, MD, Daniel Toledano, MD, Nadjib.
Definition of proximal anastomosis in the doors study

Definition of proximal anastomosis in the doors study
Direct Reimplantation as an Alternative Approach for Treatment of Anomalous Aortic Origin of the Right Coronary Artery  Kenta Izumi, MD, Manuel Wilbring,

Direct Reimplantation as an Alternative Approach for Treatment of Anomalous Aortic Origin of the Right Coronary Artery  Kenta Izumi, MD, Manuel Wilbring,
A potential window into surgical outcomes for Berry syndrome

A potential window into surgical outcomes for Berry syndrome
Neoaortic root dilatation with saccular aneurysm formation after the arterial switch operation for Taussig–Bing anomaly  Yoshitaka Hayashi, MD, PhD, Andrew.

Neoaortic root dilatation with saccular aneurysm formation after the arterial switch operation for Taussig–Bing anomaly  Yoshitaka Hayashi, MD, PhD, Andrew.
Cardiac development after salvage partial left ventriculectomy in an infant with anomalous left coronary artery from the pulmonary artery  Stephen Westaby,

Cardiac development after salvage partial left ventriculectomy in an infant with anomalous left coronary artery from the pulmonary artery  Stephen Westaby,
Standardizing definitions for hybrid coronary revascularization

Standardizing definitions for hybrid coronary revascularization
Endocarditis and extrinsic coronary compression

Endocarditis and extrinsic coronary compression
The present day potential role of fractional flow reserve–guided coronary artery bypass graft surgery  Filip Casselman, MD, PhD, FETCS, Johan Van der.

The present day potential role of fractional flow reserve–guided coronary artery bypass graft surgery  Filip Casselman, MD, PhD, FETCS, Johan Van der.
Arterial switch operation for transposition of the great arteries with anomalies of cardiac situs and aortic position  Sachin Talwar, MCh, Aandrei Jivendra.

Arterial switch operation for transposition of the great arteries with anomalies of cardiac situs and aortic position  Sachin Talwar, MCh, Aandrei Jivendra.
Confirmation of Anomalous Origin of the Right Coronary Artery From the Left Sinus of Valsalva With Magnetic Resonance Imaging  Christian Machado, M.D.,

Confirmation of Anomalous Origin of the Right Coronary Artery From the Left Sinus of Valsalva With Magnetic Resonance Imaging  Christian Machado, M.D.,
Anomalous aortic origin of a coronary artery in the Ross operation: Attention to minor details averts major problems  Igor E. Konstantinov, MD, PhD, FRACS 

Anomalous aortic origin of a coronary artery in the Ross operation: Attention to minor details averts major problems  Igor E. Konstantinov, MD, PhD, FRACS 
CD133+ cells: How could they have an IMPACT?

CD133+ cells: How could they have an IMPACT?
Aortic root translocation with atrial switch: Another surgical option for congenitally corrected transposition of the great arteries with isolated pulmonary.

Aortic root translocation with atrial switch: Another surgical option for congenitally corrected transposition of the great arteries with isolated pulmonary.

Similar presentations

Ads by Google