Shams Khaled A, Hussein Hossameldin, Romeih Soha, Elguindy Ahmed M
Department of Adult Cardiology, Aswan Heart Centre Egypt.
Department of Cardiology, Helwan University Egypt.
Interv Cardiol. 2024 Aug 28;19:e14. doi: 10.15420/icr.2023.28. eCollection 2024.
Late coronary complications after an arterial switch operation (ASO) may occur due to vessel kinking, compression resulting from growth of the great vessels, ostial fibro-intimal thickening after reimplantation or possibly secondary to accelerated atherosclerosis. Given that many of these patients are asymptomatic, adult ASO survivors require special attention and an individualised approach to the early detection of coronary artery disease. Most previously reported cases of coronary artery disease after an ASO have been managed surgically. Owing to the complex anatomy of the aortic sinuses and abnormal coronary origin, percutaneous coronary intervention may be challenging with difficult catheter engagement and/or support. Pre-procedural multi-slice CT coronary angiography can be used for proper planning and guidance. A case is described here for percutaneous coronary intervention in an adult patient who presented with coronary artery disease 33 years after an ASO.
动脉调转术（ASO）后晚期冠状动脉并发症可能由于血管扭结、大血管生长导致的压迫、再植入术后开口处纤维内膜增厚或可能继发于加速动脉粥样硬化而发生。鉴于这些患者中许多人无症状，成年ASO幸存者需要特别关注，并采用个体化方法早期检测冠状动脉疾病。大多数先前报道的ASO后冠状动脉疾病病例已通过手术治疗。由于主动脉窦解剖结构复杂且冠状动脉起源异常，经皮冠状动脉介入治疗可能具有挑战性，导管插入和/或支撑困难。术前多层CT冠状动脉造影可用于合理规划和指导。本文描述了一例成年患者在ASO 33年后出现冠状动脉疾病并接受经皮冠状动脉介入治疗的病例。
