@Article{CHD.2020.013032,
AUTHOR = {Yoann Perreux, Marie Alexandre Chaix, Anna Kamp, François-Pierre Mongeon, Magali Pham, Loïc Boussel, Roland Henaine, Annie Dore, Blandine Mondésert, Sylvie Di-Filippo, Paul Khairy, Francis Bessiere},
TITLE = {Abnormal Coronary Anatomy in Patients with Transposition of the Great Arteries and Atrial Switch: A Predictor of Serious Cardiac Adverse Events?},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {6},
PAGES = {473--482},
URL = {http://www.techscience.com/schd/v15n6/40503},
ISSN = {3071-1738},
ABSTRACT = {Sudden cardiac death and heart failure are well known long-term complications after atrial switch for D-transposition of the great arteries (D-TGA).
Right systemic ventricular dysfunction is common and myocardial ischemia has
been implicated as a putative mechanism for sudden death, with coronary anomalies prevalent in 30% of cases. We sought to assess an association between
adverse events and coronary anomalies in patients with D-TGA and atrial switch
surgery. An observational study was conducted in 3 tertiary centers (Montreal
Heart Institute, Canada, Nationwide Children’s hospital, Chicago, USA and Hopital cardiologique Louis Pradel de Lyon, France). Adults with D-TGA and atrial
switch surgery qualified for inclusion if they had a major adverse cardiovascular
event (MACE), i.e., ventricular arrhythmia, sudden cardiac death, heart failure,
cardiac transplantation, or cardiovascular death. The prevalence of coronary
anomalies was compared to historical controls. Forty-five patients were included.
Twenty-one (46.7%) patients experienced a ventricular arrhythmia and 35
(77.8%) suffered from symptomatic heart failure and/or severe right ventricular
dysfunction. Twelve patients (26.7%) had congenitally abnormal coronary
arteries. There was no difference in the prevalence of coronary anomalies between
the cohort with a MACE and a pooled population of 647 historical controls with
D-TGA (28.7%, <i>p</i> = 0.89). In conclusion, the prevalence of congenital coronary
anomalies is not higher in patients with D-TGA and atrial switch surgery who had
adverse cardiovascular events. It could be hypothesized that ischemic complications in this patient population are more likely to be related to a supply-demand
mismatch of the distal microvasculature rather than proximal coronary anomalies.},
DOI = {10.32604/CHD.2020.013032}
}