Angiographic study of aorta, coronary arteries, and left ventricular performance after neonatal arterial switch operation for simple transposition of the great arteries

Abstract

This retrospective study attempts to assess the growth pattern of the aorta and the coronary arteries and the left ventricular function approximately 1 year after neonatal arterial switch operation for simple transposition of the great arteries. Seventy-one patients underwent cardiac catheterization and cineangiocardiography an average of 13.5 months after the operation. The diameters of aortic annulus, aorta at different sites, and coronary arteries were compared with normal ranges taken from the literature. Left ventricular systolic performance was also evaluated. Observations included the following: Neoaortic annulus and root were larger than normal, trivial or mild neoaortic regurgitation was frequently observed, and the development of aortic anastomosis was normal. One patient had unexpected coronary occlusion, one had a coronary artery fistula, and two had a hypoplastic left anterior descending coronary artery. Except in one child who underwent an internal mammary bypass graft immediately after anatomic correction, the global left ventricular performance was normal. Six patients had regional wall motion abnormalities. Our midterm results are encouraging, but potential late complications remain concerns that must continue to be evaluated in long-term follow-up studies.