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The Journal of Thoracic and Cardiovascular Surgery, Vol 76, 135-139, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Vulnerability of coronary arteries in surgery for transposition of the great arteries

KR Anderson, DC McGoon and JT Lie

A detailed anatomic study of 82 hearts from patients operated upon for complete or congenitally corrected transposition of the great arteries revealed 12 instances of intraoperative injury to a major coronary artery. Because the coronary arterial anatomy is so variable in transposition of the great arteries, there is a significant risk of injury to them during operation. This is especially so if epicardial adhesions and scarring from previous operations obscure the surface anatomy of the heart. The most common site of injury was adjacent to incisions in the anterior surface of the right-sided ventricle, particularly in congenitally corrected transposition. Without a meticulous examination, these complications of cardiac surgery may be easily overlooked even when the hearts are examined at autopsy.




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