Prevalence of coronary anomalies in adolescent and young adults with D-transposition of great arteries after arterial switch operation.

Authors

João Calvão, Mariana Vasconcelos, Catarina Costa, Ana Filipa Amador, André Carvalho, João Rebelo, Jorge Moreira, Cristina Cruz, Filipe Macedo

Published in

Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology. Volume 44. Issue 12. Pages 721-726. Epub Oct 25, 2025.

Abstract

Arterial switch operation (ASO) is currently the standard surgical repair for D-transposition of great arteries (D-TGA). As the procedure implies reimplantation of the coronary arteries into the neo-aortic root, long-term coronary complications are possible and potentially dangerous. However, routine coronary evaluation after ASO remains controversial. The purpose of this study is to perform a descriptive analysis of coronary computed tomography angiography (CCTA) findings in adolescent and young adults with D-TGA after ASO.
We performed a retrospective single center study that included adolescent and young adults with D-TGA submitted to ASO who underwent CCTA. Demographic, clinical and imaging data were collected.
We identified 57 patients with D-TGA submitted to ASO. Of these, 39 performed a CCTA. Mean age of patients was 19.6 (±4.2) years; 54% were male; 32% had complex D-TGA. In 35 patients (90%), CCTA was part of routine screening. In four (10%) patients CCTA was done due to symptoms or an abnormal non-invasive test suggestive of myocardial ischemia. Eighteen (46%) patients had coronary anomalies: five (13%) had an acute angulation at the coronary origin; 13 (33%) patients had anomalous origin of the coronary arteries. Interarterial course was described in two (5%) patients and retroaortic course reported in eight (21%) cases.
Adolescent and young adults with D-TGA submitted to ASO have a high incidence of coronary anomalies. Routine screening with CCTA may be justified to identify patients who may be at higher risk of coronary events.

PMID:
42844832
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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