Case Report: Challenging Perioperative Decision-Making in a Neonate With Transposition of Great Arteries and Novel Coronary Anatomy

Madhuradhar Chegondi; Marco Ricci; Ravi C Ashwath

doi:10.3389/fped.2022.900142

Case Report: Challenging Perioperative Decision-Making in a Neonate With Transposition of Great Arteries and Novel Coronary Anatomy

Front Pediatr. 2022 Jul 6:10:900142. doi: 10.3389/fped.2022.900142. eCollection 2022.

Authors

Madhuradhar Chegondi¹, Marco Ricci^{1

2}, Ravi C Ashwath³

Affiliations

¹ Division of Critical Care Medicine, Stead Family Children's Hospital & Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States.
² Division of Pediatric Cardiac Surgery, Stead Family Children's Hospital, Iowa City, IA, United States.
³ Division of Pediatric Cardiology, Stead Family Children's Hospital, Iowa City, IA, United States.

Abstract

Transposition of great arteries (d-TGA) is often associated with various coronary artery (CA) patterns. These anomalous patterns can cause variable clinical symptoms of coronary ischemia including sudden death. CA pattern is one of the major determinants of outcome in TGA postoperatively. An advanced cardiac imaging and a multidisciplinary care approach are essential for a favorable outcome. Here, we describe a novel CA origin pattern in a neonate with d-TGA, who developed myocardial ischemia and required a coronary unroofing procedure for a full recovery.

Keywords: commissural malalignment; coronary artery pattern; intramural course; neonate; novel; perioperitave decision; transposition of great arteries (TGA).

Publication types

Case Reports