TY  - EJOU
AU  - Kwon, Hye Won 
AU  - Song, Mi Kyoung 
AU  - Lee, Sang Yun 
AU  - Kim, Gi Beom 
AU  - Cho, Sungkyu 
AU  - Kwak, Jae Gun 
AU  - Kim, Woong-Han 
AU  - Lee, Whal 
AU  - Bae, Eun Jung 

TI  - Coronary Artery Complications after Right Ventricular Outflow Tract Reconstruction Surgery
T2  - Structural and Congenital Heart Disease

PY  - 2022
VL  - 17
IS  - 3
SN  - 3071-1738

AB  - <b>Background:</b> Mechanisms and clinical manifestations of coronary artery complications after right ventricular outflow tract reconstruction surgery are not well known. <b>Methods:</b> Patients who had coronary artery complications after pulmonary valve replacement or the Rastelli procedure at a single tertiary centre were retrospectively analysed. <b>Results:</b> 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. <b>Conclusion:</b> 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.
KW  - Congenital heart disease; right ventricular outflow tract reconstruction surgery; coronary artery disease

DO  - 10.32604/chd.2022.019065