Sethi Prince, Bhatnagar Udit, Steffen Kelly, Bendaly Edgard, Stys Adam
Cardiology/internal Medicine, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center.
Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center.
Cureus. 2018 Feb 12;10(2):e2183. doi: 10.7759/cureus.2183.
The dextro-transposition of great arteries (d-TGA) is a rare, congenital, cyanotic heart disease and there is a paucity of data regarding long-term cardiovascular outcomes. We present a rare case of non-ST-elevation myocardial infarction (NSTEMI) in a patient with surgically repaired d-TGA. A 43-year-old male who had previously undergone a Mustard atrial switch palliative procedure presented with chest pain and diaphoresis and was diagnosed with NSTEMI. A coronary angiogram revealed a small, underdeveloped, left anterior descending and a large, left circumflex coronary artery with an acute embolic lesion. The embolic lesion was secondary to atrial fibrillation and was successfully treated with aspiration thrombectomy. This case highlights the variations in coronary anatomy in surgically repaired d-TGA and the importance of recognizing the potential for long-term complications in these cases.
大动脉右位转位（d-TGA）是一种罕见的先天性青紫型心脏病，关于其长期心血管结局的数据较少。我们报告一例经手术修复的d-TGA患者发生非ST段抬高型心肌梗死（NSTEMI）的罕见病例。一名43岁男性，此前接受过Mustard心房转位姑息手术，出现胸痛和出汗症状，被诊断为NSTEMI。冠状动脉造影显示左前降支细小、发育不良，左旋支粗大，伴有急性栓塞病变。栓塞病变继发于房颤，经血栓抽吸切除术成功治疗。该病例突出了经手术修复的d-TGA患者冠状动脉解剖结构的变异，以及认识这些病例中潜在长期并发症的重要性。
