Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-21T18:34:35.888Z Has data issue: false hasContentIssue false
  • English
  • Français

The size of the coronary arteries in children with complete transposition before and after the arterial switch operation

Published online by Cambridge University Press:  19 August 2008

Koichi Yatsunami ,
Makoto Nakazawa ,
Masashi Seguchi ,
Kazuo Momma  and
Yasuharu Imai
Koichi Yatsunami
Affiliation:
Departments of Pediatric Cardiology and Pediatric Cardiovascular Surgery, Heart Institute of JapanTokyo Women’s Medical College, Tokyo
Makoto Nakazawa*
Affiliation:
Departments of Pediatric Cardiology and Pediatric Cardiovascular Surgery, Heart Institute of JapanTokyo Women’s Medical College, Tokyo
Masashi Seguchi
Affiliation:
Departments of Pediatric Cardiology and Pediatric Cardiovascular Surgery, Heart Institute of JapanTokyo Women’s Medical College, Tokyo
Kazuo Momma
Affiliation:
Departments of Pediatric Cardiology and Pediatric Cardiovascular Surgery, Heart Institute of JapanTokyo Women’s Medical College, Tokyo
Yasuharu Imai
Affiliation:
Departments of Pediatric Cardiology and Pediatric Cardiovascular Surgery, Heart Institute of JapanTokyo Women’s Medical College, Tokyo
*
Dr. Makoto Nakazawa Department of Pediatric Cardiology, Heart Institute of Japan, Tokyo Women’s Medical College, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162, Japan. Tel. 81-3-3353-8111; Fax. 81-3-5269-7434.
Get access Rights & Permissions [Opens in a new window]

Abstract

The size of the coronary arteries parallels the ventricular mass, thus it may be abnormal in complete transposition beyond infancy and could be influenced by the arterial switch operation. To investigate this possibility, we measured the diameters of the right, left main trunk, anterior descending, and circumflex coronary arteries before and three to seven years (mean 4.8) after the arterial switch operation in 17 patients with a “normal” distribution of the coronary arteries (so-called Shaher type 1). The values were compared with 18 controls who had Kawasaki disease with no apparent coronary arterial disease. The right, left anterior descending, and circumflex arteries were smaller than control values before the operation. The post-/preoperative ratios of the diameter were 1.16±0.11 for the right coronary artery, 1.18±0.16 for the left main trunk, 1.20±0.18 for the left anterior descending artery, and 1.22±0.26 for the circumflex artery. There were no significant differences among these values. After surgery, the right coronary artery was larger, but the left coronary arteries were smaller in the patients than in the controls: 2.5±0.3 vs 2.0±0.2 mm for the right coronary artery; 2.4±0.3 vs 2.7±0.1 mm for the left main trunk; 1.9±0.2 vs 2.4±0.2 mm for the left anterior descending artery; 1.6±0.4 vs 2.2±0.5 mm for the circumflex artery, respectively. The posterior descending coronary artery originated from the right coronary artery in all patients. The total cross-sectional area of the right coronary, left anterior descending, and circumflex arteries was 9.7±2.4 mm2 in the patients, and 11.8±2.9 mm2 in the controls (p>O. 1), suggesting that the increased size of the right coronary artery compensates for the small left coronary arteries. We conclude that the arterial system in complete transposition, with a large right coronary artery and small left coronary system, remains smaller than normal even at midterm follow-up after anatomic repair despite normalization of left ventricular volume and muscle mass.

Keywords

Jatene operationcoronary arterial sizecoronary arterial distributionventricular muscle mass
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 4 , October 1994 , pp. 340 - 346
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Wernovsky, G, Hougen, TJ, Walsh, EP, Sholler, GF, Colan, SD, Sanders, SP, Perness, IA, Keane, JF, Mayer, JE, Jonas, RA, Castaãeda, AR, Lang, P. Midterm results after the arterial switch operation for transposition of the great arteries with intact ventricular septum: Clinical, hemodynamic, echocardiographic, and electrocardiographic data. Circulation 1988; 77: 1333–1344.Google Scholar
2.Di Donato, RM, Wernovsky, G, Walsh, EP, Colan, SD, Lang, P, Wessel, DL, Jonas, RA, Mayer, JE Jr, Castaãeda, AR. Results of the arterial switch operation for transposition of the great arteries with ventricular septal defect; Surgical consideration and midterm follow-up data. Circulation 1989; 80: 1689–1705.CrossRefGoogle ScholarPubMed
3.Colan, SD, Trowitzsch, E, Wernovsky, G, Sholler, GF, Sanders, SP, Castaãeda, AR. Myocardial performance after arterial switch operation for transposition of the great arteries with intact ventricular septum. Circulation 1988; 78: 1689–1705.CrossRefGoogle ScholarPubMed
4.Losay, J, Touchot-Kone, A, Planché, C, Lacour-Gayet, F, Serraf, A, Bruniaux, J. Midterm follow-up after arterial switch operation for transposition of the great arteries with intact septum (Abstract). Circulation 1991; 84(Suppl II): II 512. [Abstract]Google Scholar
5.Vilatafane, J, White, S, Elbl, F, Rees, A, Solinger, R. An electrocardiographic midterm follow-up study after anatomic repair of transposition of the great arteries. Am J Cardiol 1990; 66: 350–354.Google Scholar
6.Vetter, VL, Tanner, CS. Electrophysiologic consequences of the arterial switch repair of transposition of the great arteries. J Am Coll Cardiol 1988; 12: 229–237.CrossRefGoogle ScholarPubMed
7.Martin, RP, Radley-Smith, R, Yacoub, MH. Arrhythmias before and after anatomic correction of transposition of the great arteries. J Am Coll Cardiol 1987; 10: 200–204.CrossRefGoogle ScholarPubMed
8.Borow, KM, Arensman, FW, Webb, C, Radley-Smith, R, Yacoub, MH. Assessment of left ventricular contractile state after anatomic correction of transposition of the great arteries. Circulation 1984; 64: 106–112.Google Scholar
9.Lange, PE, Sievers, HH, Onnasch, DGW, Yacoub, MH, Bernhard, A, Heintzen, PH. Up to 7 years of follow-up after two-stage anatomic correction of simple transposition of the great arteries. Circulation 1986; 74 (Suppl I): I 47–I 52.Google Scholar
10.Vogel, M, Smallhorn, JF, Gilday, D, Ash, J, Souza, MD, Benson, LN, Musewe, N, Williams, WG. Assessment of myocardial perfusion at rest and after isoproterenol infusion in patients with transposition of the great arteries after the arterial switch procedure. J Nucl Med 1987; 28: 621. [Abstract]Google Scholar
11.Hutchins, GM, Bulkley, BH, Miner, MM, Boitnott, JK. Correlation of age and heart weight with tortuosity and caliber of normal human coronary arteries. Am Heart J 1977; 94: 196–202.Google Scholar
12.Roberts, CS, Roberts, WC. Cross-sectional area of the proximal portions of the three major epicardial coronary arteries in 98 necropsy patients with different coronary events: Relationship to heart weight, age and sex. Circulation 1980; 62: 1150–1153.CrossRefGoogle ScholarPubMed
13.Lewis, BS, Gotsman, MS. Relation between coronary artery size and left ventricular wall mass. Br Heart J 1973; 35: 1150–1153.CrossRefGoogle ScholarPubMed
14.O’Keefe, JH, Owen, RM, Bove, AA. Influence of left ventricular mass of coronary artery cross-sectional area. Am J Cardiol 1987; 59: 1395–1397.Google Scholar
15.Leung, WH, Stadius, ML, Alderman, EL. Determinants of normal coronary artery dimensions in humans. Circulation 1991; 84: 2294–2306.Google Scholar
16.Villari, B, Hess, OM, Meier, C, Pucillo, A, Gaglione, A, Turina, M, Krayenbuehl, HP. Regression of coronary artery dimensions after successful aortic valve replacement. Circulation 1992; 85: 972–978.CrossRefGoogle ScholarPubMed
17.Baão-Rodrigo, A, Quero-Jiménez, M, Moreno-Granado, F, Gamallo-Amet, C. Wall thickness of ventricular chambers in transposition of the great arteries: Surgical implications. J Thorac Gardiovasc Surg 1980; 79: 592–597.Google Scholar
18.Smith, A, Wilkinson, JL, Arnold, R, Dickinson, DF, Anderson, RH. Growth and development of ventricular walls in complete transposition of the great arteries with intact septum (simple transposition). Am J Cardiol 1982; 42: 362–368.CrossRefGoogle Scholar
19.Maroto, E, Fouron, JC, Douste-Blazy, MY, Carceller, AM, van Doesburg, N, Kratz, C, Davignon, A. Influence of age on wall thickness, cavity dimensions and myocardial contractility of the left ventricle in simple transposition of the great arteries. Circulation 1983; 67: 1311–1317.Google Scholar
20.Oberhoffer, RM, Ho, YS, Anderson, RH. Coronary artery diameter in the heart with complete transposition of the great vessels. J Am Coll Cardiol 1990; 15: 1433–1437.CrossRefGoogle ScholarPubMed
21.Shaher, RM, Puddu, GC. Coronary artery anatomy in complete transposition of the great vessels. Am J Cardiol 1966; 17:355–361.Google Scholar
22.Lecompte, Y, Zannini, L, Hazan, E, Jarreau, MM, Bex, JP, Tu, TV, Nevuex, JY. Anatomic correction of the complete transposition of the great arteries: New technique without use of a prosthetic conduit. J Thorac Cardiovasc Surg 1981; 82: 629–631.Google Scholar
23.Graham, TP Jr, Jarmakani, JM, Canent, RV Jr, Morrow, MN. Left heart volume estimation in infancy and children: Reevaluation of methodology and normal values. Circulation 1971; 43: 895–904.Google Scholar
24.Rackley, CE, Dodge, HT, Coble, YD Jr, Hay, RE. A method for determining left ventricular mass in man. Circulation 1954; 29: 666–671.Google Scholar
25.Rowlatt, UF. Coronary artery distribution in complete transposition. J 0Am Med Assoc 1962; 179: 269–279.Google ScholarPubMed
26.Sauer, U, Gittenberger-de Groot, AC, Peters, DR, Bühlmeyer, K. Cineangiography of the coronary arteries in transposition of the great arteries. Ped Cardiol 1983; 4(Suppl I): 25–42.Google Scholar
27.Smith, A, Arnold, R, Wilkinson, JL, Hamilton, DI, McKay, R, Anderson, RH. An anatomical study of the patterns of the coronary arteries and sinus nodal artery in complete transposition. Int J Cardiol 1986; 12: 295–304.CrossRefGoogle ScholarPubMed
28.Elliot, LP, Neufeld, HN, Anderson, RC, Adams, P. Edwards, JE. Complete transposition of the great vessels. 1. An anatomic study of sixty cases. Circulation 1963; 27: 1105–1117.Google Scholar
29.Gittenberger-de Groot, AC, Sauer, U, Oppenheimer-Dekker, A, Quaegebeur, J. Coronary arterial anatomy in transposition of the great arteries: A morphologic study. Pediatr Cardiol 1983: 4 (Suppl II):15–24.Google Scholar
30.Oberhoffer, R, Lang, D, Feilen, K. The diameter of coronary arteries in infants and children without heart disease. Eur J Pediatr 1989; 148: 389–392.CrossRefGoogle ScholarPubMed
31.Arjunan, K, Daniels, SR, Meyer, RA, Schwartz, DC, Barron, H, Kaplan, S. Coronary artery caliber in normal children and patients with Kawasaki disease but without aneurysms: An echocardiographic and angiographic study. J Am Coll Cardiol 1986; 8: 1119–1124.CrossRefGoogle ScholarPubMed
32.Ino, T. Angiographical studies on the dimension of coronary arteries in children: Part 2. Caliber and distribution of coronary arteries in congenital heart disease. Act Pediatr Jpn 1984; 26: 178–184.Google Scholar
33.Suzuki, A, Katniya, T, Ono, Y, Takahashi, N, Naito, Y, Kou, Y. Indication of aortocoronary by-pass for coronary arterial obstruction due to Kawasaki disease. Heart Vessel 1985; 1: 94–100.CrossRefGoogle ScholarPubMed
34.Arensman, FW, Radley-Smith, R, Yacoub, MH, Lange, P, Bernhard, A, Sievers, HH, Heintzen, P. Catheter evaluation of left ventricular shape and function 1 or more years after anatomic correction of transposition of the great arteries. Am J Cardiol 1983; 52: 1079–1083.CrossRefGoogle ScholarPubMed
35.Shulman, ST. Kawasaki Disease. Progress in Clinical and Biological Research, Volume 250. Alan R. Liss, Inc., New York, 1987.Google Scholar
36.Hiraishi, S, Yashiro, K, Kusano, S. Noninvasive visualization of coronary arterial aneurysm in infants and young children with mucocutaneous lymph node syndrome with two-dimensional echocardiography. Am J Cardiol 1979; 43: 1225–1233.Google Scholar
37.Satomi, G, Nakamura, K, Narai, S, Takao, A. Systematic visualization of coronary arteries by two-dimensional echocardiography in children and infants: Evaluation in Kawasaki’s disease and coronary arteriovenous fistulas. Am Heart J 1984; 107: 497–505.Google Scholar