Abstract 10214: Coronary Artery Anatomy in Congenital Heart Disease with Posterior Aorta: Medical and Surgical Implications

Background: Since Van Praagh's report of transposition of the great arteries (TGA) with posterior aorta, it is well known that this entity, with aortopulmonary rotation (APR) >right lateral 90°, usually had the coronary artery pattern of a normal heart (pattern IX), which is a mirror-image to the usual pattern seen in TGA with anterior aorta (pattern I). We hypothesize that various coronary artery patterns might exist in other congenital heart diseases with posterior aorta, to which we pose its implications. Methods: Coronary artery patterns and APR were identified in 665 patients that presented from 1960 to 2008 with TGA (n=76), tetralogy of Fallot (TF) (n=517), congenitally corrected transposition (CCT) (n=62), and anatomically corrected malposition (ACM) (n=10). The APR was deduced by the aortic sinus patterns via angiography at the lateral projection. Results: The coronary artery patterns in all 665 patients are shown in the Table. Posterior aorta could be identified as the nonfacing sinus located in ...