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Eur J Cardiothorac Surg 2005;27:518-519
© 2005 Elsevier Science NL

Case report

Unusual presentation of myocardial ischemia after arterial switch operation

Gürkan Çetina,*, Levent Saltikb, Ahmet Özkaraa, Kadir Babaoglub

a Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
b Department of Pediatric Cardiology, Medical School of Cerrahpasa, Istanbul University, Istanbul, Turkey

Received 7 October 2004; accepted 20 December 2004.

* Corresponding author. Address: Acibadem Caddesi, Erdem Sok., Öz Sitesi 5/C Blok D:4, Üsküdar, 81020 Istanbul, Turkey. Tel.: +90 216 3252979/532 2724272; fax: +90 212 4592069. (E-mail: gurkan{at}istanbul.edu.tr).

Ischemic changes and acute or subacute cardiac failure after arterial switch operation generally results from imperfect transfer of coronary arteries to the neoaorta. Peroperative and early postoperative myocardial ischemia is the main cause of death in these patients. We present an unusual cause of myocardial ischemia and cardiac failure after arterial switch: a congenital coronary artery fistula between the circumflex artery and the right ventricle. The symptoms imitate coronary translocation failure. In differential diagnosis of the coronary perfusion problems encountered after the arterial switch operation, coronary artery fistula should not be forgotten, although it is rare.

Key Words: Arterial switch • Coronary arteriovenous fistule • Ischemia






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Copyright © 2005 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.