Abstract：
To review the early and intermediate outcomes of patients with transposition of the great arteries (TGA) and intramural coronary artery (IMCA) who underwent arterial switch operation (ASO) at our center. Among 450 patients with TGA who underwent an ASO between 2010 and 2018, 26 (5.8%) patients were identified with IMCA. The left coronary artery was intramural in 21 of 26 patients. We adopted coronary transfer using double coronary buttons with unroofed intramural course for all 26 patients. Early mortality for patients with IMCA was 3 of 26 (11.5%) compared with 10 of 424 (2.4%) for those without IMCA (p = 0.007). Six patients suffered major adverse events, including extracorporeal membrane oxygenation support in 3 patients, delayed sternal closure in 6 patients. The follow-up was available for all 23 survivors, with the mean follow-up period of 73.5 ± 28.7 months. There was no late death and reinterventions, and all patients were asymptomatic at last follow-up. One patient exhibited moderate neopulmonary regurgitation, and 1 patient presented with distal stenosis of the right pulmonary artery. Coronary transfer using double coronary buttons with unroofed intramural course was a good option for patients with TGA and IMCA. With this technique, ASO could be performed with optimal early and intermediate outcomes.
摘要：
回顾在我们中心接受动脉转换手术（ASO）的大动脉转位（TGA）和壁内冠状动脉（IMCA）患者的早期和中期结局。在2010年至2018年间接受ASO的450例TGA患者中，有26例（5.8％）患者被确定为IMCA。26例中有21例患者的左冠状动脉位于壁内。我们对所有26例患者都采用了双冠状动脉按钮和无顶壁内病程的冠状动脉转移。患有IMCA的患者的早期死亡率为26人中的3人（11.5％），而没有IMCA的患者为424人中的10人（2.4％）（p=0.007）。6例患者发生重大不良事件,包括3例患者的体外膜氧合支持，6例延迟胸骨闭合。所有23名幸存者都可以进行随访，平均随访73.5±28.7个月。没有晚期死亡和再干预，所有患者在末次随访时无症状。一名患者表现出中度新肺返流，1例患者出现右肺动脉远端狭窄。对于患有TGA和IMCA的患者，使用双冠状动脉按钮和无顶壁内路线的冠状动脉转移是一个不错的选择。有了这项技术,ASO可以以最佳的早期和中期结果进行。
