Abstract
Introduction. Reimplantation of the coronary arteries is the key to a successful operation. Coronary arteries are located typically in
67–72% of patients with transposition of the main arteries (TMA) (ie, the left coronary artery departs from the sine that lies to the right
and the right coronary artery from the sinus of the aortic root, which is located on the left). In approximately 1/3 of all patients with
TMA, the left envelope artery (18–22% of cases) is the branch of the right coronary artery, 9.5% have a single right coronary artery
and 3% have a single left coronary artery.
Material and methods. Between 1999 and 2016, the arterial switch operation was performed in 248 children in the department of
emergency surgery of newborns. The average age of patients at the time of the operation of arterial switching was 9.9±3.5 days (minimum
0 days, maximum 165 days). One-stage surgical treatment was performed in 235 (94.8%) patients, a two-stage correction of
the defect was 13 (5.2%) in patients. 84 (34.9%) the patient underwent Raskind's procedure, in connection with the restrictive open
oval window. Of all the patients (248) who underwent arterial switch operation, 21 (8.4%) had an anatomy of a single coronary artery.
Results. In the late period, 16 (84%) of the 19 patients discharged from the department of emergency surgery of newborns with SCA
were observed. The average follow-up time was 2.9±1.9 years (from 35 days to 12.5 years). Survival for all operated patients with
SCA by 6 months was 95%, by 10 years 84%. In 3 (15.8%) of the dead children with SCA there were: in 2 – the only right coronary
artery, 1 – the left coronary artery. According to pathologists in 1 case, the death of a child of coronary genesis (single right coronary
artery) at the age of 9 months, 1 child died as a result of an accident in 1 year, 1 against a background of an infection of an unknown
genesis.
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About the authors
- Inessa E. Nefedova, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-9221-051X;
- David O. Berishvili, Dr Med. Sc., Head of Department, orcid.org/0000-0001-7379-345X;
- Manolis G. Pursanov, Dr Med. Sc., Head of Department, orcid.org/0000-0002-1421-1795;
- Irina Yu. Baryshnikova, Cand. Med. Sc., Researcher, orcid.org/0000-0001-8071-2531;
- Aleksandr A. Esayan, Cand. Med. Sc., Senior Researcher, orcid.org/0000-0002-6675-6623
