Diagnosis of coronary arterial anatomy of patients with arterial switch operation using echocardiography

Objective To evaluate the accuracy of preoperative diagnosis on the anatomy of coronary artery of patients with arterial switch operation(ASO) using echocardiography, to conclude the diagnostic methods. Methods From March 2007 to March 2008,50 patients were performed ASO after the diagnosis with eehoeardiography. Prior to the operation, evaluation was conducted to all of anatomical pattern of the coronary artery,and the comparison was made to the observation in the operation. There were 23 patients with complete transposition of great artery(TGA), 20 patients with double outlet of right ventricle of abnormal great artery(DORV), 2 patients with corrected transposition of the great arteries(CTGA), 1 patients with double outlet of left ventricle of abnormal great artery (DOLV), 2 patients with TGA complicated with total anomalous pulmonary venous connection (TGA + TAPVC), 2 patients with TGA complicated with pulmonary valve stenosis(TGA + PS). Results Among 50 patents,there were 40 patients with normal coronary artery,and 10 patients with abnormal coronary arteries. Except for 2 patients failing to being successfully diagnosed due to bad condition of image,48 patients could be revealed the origin and the direction of the major coronary arteries, the visibility proportion was 96.0%. Compared to the observation in the operation,the total echocardiography accuracy for 48 patients was 95.8%. Among the 40 patients with normal coronary arteries,39 patients were diagnosed accurately except 1 patient failed to be showed clearly by echo. In the 10 patients with abnormal coronary arteries,4 patients with single abnormal coronary artery, 2 patients with 2 coronary artery originating from the same coronary sinus, 2 patients with left anterior descending coronary artery originating from right coronary artery, 2 patients with 2 coronary artery originating from two adjacent coronary sinus. One patient failed to be diagnosed by echo for the bad image,2 patients was misdiagnosed by echo, the accuracy of echo was 77.8%. Conclusions Through multi-section scanning,echocardiography can accurately diagnose anatomical pattern of coronary artery for most of ASO,thus providing comprehensive and accurate diagnosis information for ASO. Key words: Echocardiography; Transposition of great vessels; Coronary vessel anomalies