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Case Reports
. 2018 Feb 12;10(2):e2183.
doi: 10.7759/cureus.2183.

A Rare Case of Coronary Artery Embolism in a Patient with d-Transposition of the Great Arteries with Prior Mustard Repair

Prince Sethi  1 , Udit Bhatnagar  2 , Kelly Steffen  2 , Edgard Bendaly  3 , Adam Stys  2
Affiliations
Case Reports

A Rare Case of Coronary Artery Embolism in a Patient with d-Transposition of the Great Arteries with Prior Mustard Repair

Prince Sethi et al. Cureus. .

Abstract

The dextro-transposition of great arteries (d-TGA) is a rare, congenital, cyanotic heart disease and there is a paucity of data regarding long-term cardiovascular outcomes. We present a rare case of non-ST-elevation myocardial infarction (NSTEMI) in a patient with surgically repaired d-TGA. A 43-year-old male who had previously undergone a Mustard atrial switch palliative procedure presented with chest pain and diaphoresis and was diagnosed with NSTEMI. A coronary angiogram revealed a small, underdeveloped, left anterior descending and a large, left circumflex coronary artery with an acute embolic lesion. The embolic lesion was secondary to atrial fibrillation and was successfully treated with aspiration thrombectomy. This case highlights the variations in coronary anatomy in surgically repaired d-TGA and the importance of recognizing the potential for long-term complications in these cases.

Keywords: atrial fibrillation; mustard repair; transposition of the great arteries.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Electrocardiogram showing atrial fibrillation with non-specific ST-T wave changes.
Figure 2
Figure 2. Left circumflex artery with acute embolic obstruction in the distal left circumflex artery, as shown by arrow
Figure 3
Figure 3. Left circumflex artery with acute embolic obstruction in the distal left circumflex artery, as shown by arrow
Figure 4
Figure 4. Large and patent right coronary artery
Figure 5
Figure 5. Post manual aspiration thrombectomy with resolution of embolic lesion and improved angiographic flow
See this image and copyright information in PMC

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