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Coronary Artery Complications after Right Ventricular Outflow Tract Reconstruction Surgery

Hye Won Kwon1,2, Mi Kyoung Song1, Sang Yun Lee1, Gi Beom Kim1, Sungkyu Cho2, Jae Gun Kwak2, Woong-Han Kim2, Whal Lee3, Eun Jung Bae1,*

1 Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
2 Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
3 Department of Radiology, Seoul National University Hospital, Seoul, South Korea

* Corresponding Author: Eun Jung Bae. Email: email

Congenital Heart Disease 2022, 17(3), 281-295. https://doi.org/10.32604/chd.2022.019065

Abstract

Background: Mechanisms and clinical manifestations of coronary artery complications after right ventricular outflow tract reconstruction surgery are not well known. Methods: Patients who had coronary artery complications after pulmonary valve replacement or the Rastelli procedure at a single tertiary centre were retrospectively analysed. Results: Coronary artery complications were identified in 20 patients who underwent right ventricular outflow tract reconstruction surgery. The median age at diagnosis of coronary artery complication was 21 years (interquartile range: 13–25 years). Mechanisms of coronary artery complications were compression by adjacent materials in 12 patients, dynamic compression of intramural course of coronary artery in two patients, and intraoperative injury in six patients. Congenital coronary artery anomalies were identified in 50% (10/20) of patients. Four patients presented with early postoperative haemodynamic instability. Fourteen patients showed late onset symptoms or signs of coronary insufficiency, including chest pain, ventricular dysfunction, or ventricular arrhythmias. Coronary artery stenosis was incidentally found on cardiac computed tomography angiography in two asymptomatic patients. Four patients underwent surgical interventions, and one patient underwent percutaneous coronary intervention for coronary stenosis. One patient with recurrent ventricular tachycardia required an implantable cardioverter-defibrillator. There were two deaths in patients with intraoperative coronary injury. Conclusion: Preoperative coronary evaluation and long-term follow-up for the development of coronary artery complications are required in patients undergoing right ventricular outflow tract reconstruction surgery to prevent ventricular dysfunction, arrhythmias, and death, especially among those with congenital coronary anomalies.

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APA Style
Kwon, H.W., Song, M.K., Lee, S.Y., Kim, G.B., Cho, S. et al. (2022). Coronary artery complications after right ventricular outflow tract reconstruction surgery. Congenital Heart Disease, 17(3), 281-295. https://doi.org/10.32604/chd.2022.019065
Vancouver Style
Kwon HW, Song MK, Lee SY, Kim GB, Cho S, Kwak JG, et al. Coronary artery complications after right ventricular outflow tract reconstruction surgery. Congeni Heart Dis. 2022;17(3):281-295 https://doi.org/10.32604/chd.2022.019065
IEEE Style
H.W. Kwon et al., "Coronary Artery Complications after Right Ventricular Outflow Tract Reconstruction Surgery," Congeni. Heart Dis., vol. 17, no. 3, pp. 281-295. 2022. https://doi.org/10.32604/chd.2022.019065



cc This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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