Key result
Among 18 patients with intramural coronary arteries undergoing arterial switch operation, there were 3 deaths (16.7%), with 14 surviving patients free of re-intervention at a mean of 68 months.
Why the study?
To evaluate the outcomes of arterial switch operation in patients with intramural coronary arteries.
What are the clinical outcomes of the arterial switch operation in pediatric patients with intramural coronary arteries?
Observational (n=18)
No
What are the clinical outcomes of the arterial switch operation in pediatric patients with intramural coronary arteries?
The arterial switch operation demonstrates favorable long-term outcomes in the rare subgroup of patients with intramural coronary arteries, with most survivors remaining free of re-intervention.
Supports ASO feasibility in this rare subgroup; leaves open need for larger prospective studies before practice change.
ABSTRACTObjectives: To evaluate the outcomes of arterial switch operation (ASO) in a subgroup of patients who had intramural coronary arteries at National Children’s Hospital. Methods: From 2010 to 2016, 304 patients underwent ASO at National Children’s Hospital. In which, eighteen (5.9%) had intramural coronary arteries. These medical records of these patients were collected and retrospectively reviewed.Results: There were 10 male and 8 female in this group of patients. Patients with intramural coronary arteries had transposition of the great arteries (83.3%, n = 15) or Taussig - Bing anomaly (16.7%, n = 3). At the time of surgery, mean age was 69.5 ± 81.5 [11 - 321] days and mean weight was 3.9 ± 1.1 [2.5 - 6.3] kg. Mean bypass time and mean aortic cross - clamped time were 235 ± 90 [168 - 564] minutes and 149 ± 29 [100 - 255] minutes respectively. There were 3 deaths (16.7%): two hospital deaths (at 6 days and 26 days after ASO), one death after discharge (2 months later). One patient lost follow - up. Other 14 patients are in a good health status after discharge and free of re - intervention or reoperation related to the total correction with the mean follow - up time of 68.0 ± 38.5 [2 - 113] months.Conclusions: Intramural coronary arteries remain a rare coronary anatomic variant following ASO. The outcomes of ASO in this subgroup of patients is quite favorable. Long - term follow - up is necessary.
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A 2021 study conducted an observational in Intramural coronary arteries in patients undergoing arterial switch operation (n=18). Arterial switch operation was evaluated on Mortality. Among 18 patients with intramural coronary arteries undergoing arterial switch operation, there were 3 deaths (16.7%), with 14 surviving patients free of re-intervention at a mean of 68 months.
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