Left ventricular ischemia after arterial switch procedure: Role of myocardial perfusion scintigraphy and cardiac CT

J Nucl Cardiol. 2020 Apr;27(2):651-658. doi: 10.1007/s12350-019-01738-4. Epub 2019 May 22.

Abstract

Transposition of the great arteries is a congenital heart defect defined by an abnormal connection between the aorta, pulmonary artery, and the ventricles, resulting in parallel systemic and pulmonary circulations. Long-term follow-up data of patients who underwent correction via an arterial switch operation have recently shown that as a result of re-implantation of the coronary arteries in the neo-aorta, coronary stenosis and occlusion are relatively common complications. In this report, we discuss two cases illustrating the added value of myocardial perfusion imaging (MPI) and cardiac CT for the assessment of these patients. Based on the available literature we conclude that MPI and cardiac CT are excellent non-invasive methods to evaluate coronary anatomy and myocardial function also in this specific group of patients.

Keywords: CT; Gated SPECT; Myocardial ischemia and infarction; SPECT.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Coronary Angiography / methods
  • Coronary Stenosis
  • Coronary Vessels / physiopathology
  • Exercise
  • Heart / physiopathology
  • Heart Ventricles / diagnostic imaging*
  • Humans
  • Male
  • Myocardial Ischemia / diagnostic imaging*
  • Myocardial Perfusion Imaging / methods*
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radionuclide Imaging / methods*
  • Risk
  • Tomography, Emission-Computed, Single-Photon
  • Tomography, X-Ray Computed / methods*
  • Transposition of Great Vessels / physiopathology

Substances

  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • technetium tc-99m tetrofosmin