Outcomes of arterial switch operation in patients with intramural coronary arteries at National Children’s Hospital

Abstract

Objectives: 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.