Abstract
The arterial switch operation is the operation of choice in the treatment of transposition of the great arteries. Important is the anatomy
of the coronary arteries in the transposition of the great arteries. Various anatomical abnormalities of the coronary arteries can
complicate the arterial switch operation. The most significant intraoperative risk factors are associated with the intramural course of
the coronary arteries. However, in a number of cases, there is a single coronary artery, which is an extreme variant of the intramural
coronary artery. The clinical case described in this article demonstrates successful arterial switch operation for transposition of the
great arteries with the removal of coronary arteries by a single entrance in the early neonatal period, using the technique of dividing
a single common entrance.
References
1. Ильин А.С., Теплов П.В., Сакович В.А., Спичак Ю.Ю.,
Ильиных К.А., Афанасьев И.С. и др. Метод реимплантации
коронарных артерий при операциях артериального
переключения. Детские болезни сердца и сосудов. 2014;
4: 24–9.
2. Quaegebeur J.M., Rohmer J., Ottenkamp J., Buis T.,
Kirklin J.W., Blackstone E.H. et al. The arterial switch operation:
An eight year experience. J. Thorac. Cardiovasc. Surg.
1986; 92: 361–84.
3. Kirklin J.W., Blackstone E.H., Tchervenkov C.I., Castaneda
A.R. Clinical outcomes after the arterial switch operation for
transposition. Patient, support, procedural and institutional
risk factors. Circulation. 1992; 86: 1501–15.
4. Kado H., Asoh T., Imoto Y., Shiokawa Y., Yamasaki M.,
Yasui H. Reoperation for transposition of the great arteries:
mid-term results and reoperation after arterial switch operation.
Rinsho Kyobu Geka. 1994; 14: 192–7.
5. Conte S., Jacobsen J.R., Jensen T., Hansen P.B., Helvind M.,
Lauridsen P. et al. Is the arterial switch operation still a challenge
in small centers? Eur. J. Cardiothorac. Surg. 1997; 11:
682–6.
6. Massin M.M., Nitsch G.B., Dabritz S., Seghaye M.C.,
Messmer B.J., von Bernuth G. Growth of the pulmonary artery
after arterial switch operation for simple transposition of the
great arteries. Eur. J. Pediatr. 1988; 157: 95–100.
7. Massin M.M., Nitsch G.B., Dabritz S., Messmer B.J.,
von Bernuth G. Angiographic study of aorta, coronary arteries,
and left ventricular performance after neonatal arterial switch
operation for simple transposition of the great arteries. Am.
Heart J. 1997; 134: 298–305.
8. Fricke T.A., Bulstra A.E., Loyer B.R., Weintraub R.G, d'Udekem
Y., Brizard Ch.P., Konstantinov I.E. Outcomes of the arterial
switch operation in children less than 2.5 kilograms. Ann.
Thorac. Surg. 2017; 103: 840–4.
9. Mosca R.S. Neopulmonary reconstruction: operam do.
J. Thorac. Cardiovasc. Surg. 2015; 150 (4): 926–7.
10. Базылев В.В., Черногривов А.Е. Хирургическое лечение
транспозиции магистральных артерий. Детские болезни
сердца и сосудов. 2016; 13 (1): 33–41.
11. Исакова Е.Н., Горностаев В.В., Базылев В.В., Пичугин В.В.
Факторы риска развития и интенсивная терапия синдрома
низкого сердечного выброса у детей после операций по по-
воду транспозиции магистральных артерий. Медицинский
альманах. Кардиохирургия. 2015; 3 (38): 114–20.
12. Vouhe P.R., Haydar A., Ouaknine R., Albanese S.B.,
Mauriat P., Pouard P., Tamisier D., Leca F. Arterial switch operation:
a new technique of coronary transfer. Eur. J.
Cardiothorac. Surg. 1994; 8 (2): 74–8.
13. Sung Si Ch., Chang Y.H., Lee H.D., Kim S., Woo J.S., Lee Y.S.
Arterial switch operation for transposition of the great arteries
with coronary arteries from a single aortic sinus. Ann. Thorac.
Surg. 2005; 80: 636–41.
14. Белозеров Ю.М. Детская кардиология. М.: МЕДпресс-
информ; 2004.
15. Малов А.Е. Особенности локализации устьев венечных
артерий и углов отхождения их проксимальных сегментов в
обычно сформированных сердцах и при транспозиции
магистральных сосудов. Морфология. 2011; 5 (1): 27–32.
16. Khairy, P., Clair M., Fernandes S.M., Blume E.D., Powell A.J.,
Newburger J.W., Landzberg M.J., Mayer J.E. Cardiovascular
outcomes after the arterial switch operation for d-transposition
of the great arteries. Circulation. 2013; 127: 331–9.
17. Бокерия Л.А., Шаталов К.В. (ред.) Детская кардиохирур-
гия: Руководство для врачей. М.: НЦССХ им А.Н. Бакулева;
2016.
18. Van Praagh R., Jung W.K. The arterial switch operation in
transposition of the great arteries: anatomic indications and
contraindications. Thorac. Cardiovasc. Surg. 1991; 39 (2):
138–50.
19. Park M.K. Pediatric cardiology for practitioners. 5th ed. Mosby;
2008; 226.
20. Sung C., Chang Y.H., Lee H.D., Kim M.D., Woo J.S., Lee Y.S.
Arterial switch operation for transposition of the great arteries
with coronary arteries from a single aortic sinus. Ann. Thorac.
Surg. 2005; 80: 636–41.
21. Довгань А.М., Горячев А.Г., Храпунов В.Н., Бойко С.Н.,
Яковенко И.Г., Витовский Р.М. Операция артериального
переключения при транспозиции магистральных артерий
со сложными вариантами отхождения коронарных
артерий. Сердце и сосуды. 2007; 1 (17): 75–80.
22. Altin F.H., Sengul F.S., Yildiz O., Tosun O., Ozturk E.,
Kyaruzi M. et al. Impact of coronary artery anatomy in arterial
switch procedure on early mortality and morbidity. Congenit.
Heart Dis. 2016; 11 (2): 115–21.
About the authors
- Gulasaryan Ruben Sergeevich, Cand. Med. Sc., Senior Researcher, orcid.org/0000-0001-7664-8506;
- Tumanyan Margarita Rollandovna, Dr Med. Sc., Professor, Head of Department, orcid.org/0000-0003-4250-8198;
- Kim Aleksey Ivanovich, Dr Med. Sc., Professor, Head of Department, orcid.org/0000-0002-1759-9895