Review <p>Objective: To analyse the long-term patency of coronary ar- <br />teries after neonatal arterial switch operation (ASO). Meth- <br />ods: A retrospective study of the operative reports, follow- <br />up and postoperative catheterisation data of 119 patients, <br />who underwent the great arteries (TGA) repair since 1991, <br />has been carried out. Patient population: Among the 133 <br />survivors of the 137 ASOs performed between 1991 and <br />2007, 119 patients have been studied by routine control car- <br />diac catheterisation and form the study population. Median <br />time between repair and the coronary angiography was 2.9 <br />&plusmn; 1.9 years. A comparison between the eight patients (6.7% <br />out of the entire study population), known to have postop- <br />erative coronary obstructions (group I) and the rest of the <br />cohort with angiographic normal coronary vessels (group <br />II) was performed by univariate analysis of variance and <br />logistic regression models. One patient had surgical plasty <br />of the left coronary main stem with subsequent percutane- <br />ous angioplasty, three patients had primary coronary stent <br />implantation and four patients had no further intervention at <br />all. In group I, all but one patient denied symptoms of chest <br />pain and echocardiography failed to show any difference <br />between the two groups in terms of left ventricular systolic <br />function (ejection fraction group I 61 &plusmn; 2% vs 62 &plusmn; 6% of <br />group II, p = 1.0). Results: The association of coronary ob- <br />struction with complex native coronary anatomy (Yacoub <br />type B to E) was evident at both univariate (62% of group <br />I vs 22% of group II, p = 0.04) and logistic regression (p = <br />0.007, odds ratio (OR) 8.1) models. The type of coronary <br />reimplantation (i.e., coronary buttons on punch vs trap-door <br />techniques) was similar between the two groups (punch re- <br />implantation in 25% of patients of group I vs 31% of group <br />II, p = 0.1) as was the relative position of the great vessels <br />(aorta anterior in 100% of patients of group I vs 96% of <br />group II; univariate, p = 0.1). Conclusions: The late out- <br />come in terms of survival and functional status after ASO <br />is excellent. Nevertheless, the risk of a clinically silent late <br />coronary artery obstruction of the reimplanted coronary ar- <br />teries warrants a prolonged follow-up protocol involving <br />invasive angiographic assessment.</p> Transposition of the great arteries • Arterial switch operation • Coronary arteries 0 0 http://www.iscs.org.ir/journals/vol.3/no.1/299/