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J Thorac Cardiovasc Surg 2007;134:1064-1065
© 2007 The American Association for Thoracic Surgery

Brief Communication

Arterial switch in a 1146-gram neonate with transposition of the great arteries and an intramural coronary artery

^a Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
^b Department of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan
^c Department of Pediatrics, Japanese Red Cross Medical Center, Tokyo, Japan.

Received for publication May 25, 2007; accepted for publication June 14, 2007.

^_* Address for reprints: Yukihiro Kaneko, MD, Department of Cardiovascular Surgery, Japanese Red Cross Medical Center 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan. (Email: yukihirokaneko@hotmail.com).

The first 20% of the full text of this article appears below.

A male monozygotic twin weighing 1146 g delivered at 31 weeks’ gestation was cyanotic. An echocardiogram disclosed a simple complete transposition of the great arteries. The right and left coronary arterial orifices were located in sinus 2 (right posterior facing sinus).¹ The left coronary artery was hypoplastic, had an intramural course between the great arteries, and gave rise to the left anterior descending artery and the circumflex artery. The aortic root was located anterior and 30 degrees to the right of the pulmonary arterial root. The diameters of the aorta and the pulmonary trunk were 6 mm and 8 mm, respectively.

Clinical Summary

Balloon atrial septostomy was not performed because there was acceptable interatrial communication and an appropriately sized balloon catheter was not available. Prostaglandin E1 was given to maintain ductus arteriosus patency.

Surgery was performed at age 14 days, when the patient weighed 1103 g. Through a median sternotomy, cardiopulmonary bypass with aortic and bicaval cannulation . . . [Full Text of this Article]