Coronary arterial anatomy in complete transposition of the great vessels

Abstract

The coronary arterial anatomy in 149 specimens of complete transposition of the great vessels was studied. Nine different patterns emerged. The two most common patterns are (1) origin of the left coronary artery from the left aortic sinus, and the right coronary artery from the posterior sinus, and (2) origin of the right coronary artery and the left circumflex artery from the posterior sinus, and the anterior descending artery from the left sinus. No definite pattern could be correlated to the presence or absence of ventricular septal defect, or the presence or absence of left ventricular outflow tract obstruction. The surgical concern in regard to the coronary arterial anatomy in complete transposition was discussed and it was pointed out that one or more branches of the left coronary artery may be found at the site of incisions in either ventricle. Of the 23 specimens with left ventricular outflow tract obstruction, the left circumflex artery coursed in front of the left ventricle in 16.