Abstract 18740: Cardiac Magnetic Resonance Evaluation of Coronary Anatomy and Myocardial Viability After Arterial Switch Operation
Background: Arterial Switch Operation (ASO) is the treatment of choice for anatomic correction of transposition of the great arteries (TGA). One of the major concerns after ASO is the evaluation of the translocated coronary arteries. There are limited studies evaluating the role of cardiac magnetic resonance (CMR) in the follow up of patients after ASO. The purpose of this study is to evaluate the extensive use of CMR for delineating coronary artery anatomy and myocardial viability after ASO.
METHODS: Retrospective review of 69 consecutive CMR Whole Heart T2 Prep coronary angiography studies of patients who underwent ASO for TGA. The subjects had CMR from July 2005 to December 2012. Results of inversion recovery viability imaging were also reviewed.
RESULTS: The median age at the time of CMR was 15 years with range of 1 year to 24 years); 44 male and 25 female subjects. The coronary origins and proximal coronary arteries were well demonstrated by CMR in 97% (67/69) of the cases Among these, 70% (47/67) of the cases had typical coronary pattern for TGA after ASO while 30% (20/67) had an atypical pattern. Circumflex coronary artery arising from right coronary artery was seen in 60% (12/20) and single coronary artery originating from right or left facing sinus was identified in 40% (8/20) of the subjects with atypical coronary pattern. One patient had evidence of left circumflex coronary artery occlusion with inferior and lateral myocardial fibrosis on late gadolinium enhancement imaging. In this patient, the right coronary artery originates from right facing sinus and the left coronary artery originates from left facing sinus. The two patients with unsatisfactory image quality had dental brace artifact affecting image quality.
Conclusions: CMR coronary angiography and myocardial viability can reliably delineate coronary anatomy and identify myocardial fibrosis after ASO for TGA.
Keywords: Arterial switch operation; Cardiovascular magnetic resonance imaging; Transposition of great arteries
- © 2013 by American Heart Association, Inc.