Arterial switch operation in a child with commissural malalignment and unusual coronary anatomy

• Published in: Multimedia manual of cardiothoracic surgery Vol. 2024
• Main Authors: Konstantinov, Igor E, Moscoso, Bosco, Fricke, Tyson A, Zubritskiy, Alexey, Lijanto, Regina Marliau
• Format: Journal Article
• Language: English
• Published: England 22.05.2024
• Subjects: Arterial Switch Operation - adverse effects; Arterial Switch Operation - methods; Coronary Vessel Anomalies - diagnosis; Coronary Vessel Anomalies - surgery; Coronary Vessels - diagnostic imaging; Coronary Vessels - surgery; Humans; Infant, Newborn; Male; Transposition of Great Vessels - surgery; Transposition of the great arteries
• ISSN: 1813-9175
• DOI: 10.1510/mmcts.2024.027

The arterial switch operation has evolved to become the treatment of choice for transposition of the great arteries and is one of the greatest success stories in congenital heart surgery. The most crucial step of the operation is the coronary artery translocation; therefore, it is of paramount importance for surgeons to know every single detail about the morphology and spatial relationships of the coronary arteries and the roots of the great vessels. However, sometimes the surgeon may face unfavourable scenarios such as major commissural malalignment and anomalous coronary artery patterns and need to be prepared to carry out a successful coronary artery translocation. Herein, we demonstrate that the trapdoor technique is useful for transferring coronary arteries in a neonate with major commissural malalignment and unusual coronary anatomy during the arterial switch operation.