ANGIOGRAPHIC STUDY OF AORTA, CORONARY-ARTERIES, AND LEFT-VENTRICULAR PERFORMANCE AFTER NEONATAL ARTERIAL SWITCH OPERATION FOR SIMPLE TRANSPOSITION OF THE GREAT-ARTERIES

This retrospective study attempts to assess the growth pattern of the aorta and the coronary arteries and the left ventricular function appr oximately 1 year after neonatal arterial switch operation for simple t ransposition of the great arteries. Seventy-one patients underwent car diac catheterization and cineangiocardiography an average of 13.5 mont hs after the operation. The diameters of aortic annulus, aorta at diff erent sites, and coronary arteries were compared with normal ranges ta ken from the literature. Left ventricular systolic performance was als o evaluated. Observations included the following: Neoaortic annulus an d root were larger than normal, trivial or mild neoaortic regurgitatio n was frequently observed, and the development of aortic anastomosis w as normal. One patient had unexpected coronary occlusion, one had a co ronary artery fistula, and two had a hypoplastic left anterior descend ing coronary artery. Except in one child who underwent an internal mam mary bypass graft immediately after anatomic correction, the global le ft ventricular performance was normal. Six patients had regional wall motion abnormalities. Our midterm results are encouraging, but potenti al late complications remain concerns that must continue to be evaluat ed in long-term follow-up studies.