Recombinant t-PA in myocardial ischemia after switch operation.

A well-recognized complication of the anatomic correction (arterial switch operation) of transposition of the great arteries is obstruction of the translocated coronary arteries. Myocardial reperfusion has previously been achieved by surgical revascularization or percutaneous balloon angioplasty. We report the case of a 3-month-old infant who suffered myocardial infarction 11 weeks after the arterial switch operation, in whom myocardial reperfusion was established following infusion of recombinant tissue-type plasminogen activator (Alteplase).