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Image challenge
Imaging large arteries after arterial switch operation
  1. Iris van Broekhoven1,
  2. Lucia J M Kroft2,
  3. Roel L F van der Palen1
  1. 1 Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr Roel L F van der Palen, Pediatric Cardiology, Leiden University Medical Center, Leiden 2333 ZA, The Netherlands; R.L.F.van_der_Palen{at}lumc.nl

https://doi.org/10.1136/heartjnl-2019-316504

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    Clinical introduction

    A girl born at a gestational age of 38 weeks was antenatally diagnosed with a transposition of the great arteries with intact ventricular septum. After a balloon atrioseptostomy in the first hour postbirth an arterial switch operation (ASO), including Lecompte manoeuvre, was successfully performed at day 8. Coronary arteries were implanted in the neoaortic root with the button technique. The proximal neoaorta was anastomosed to the distal ascending aorta by a running suture. Reconstruction of the neopulmonary artery after harvesting the coronary arteries was performed using a pantaloon shaped patch of fresh autologous pericardium. The proximal neopulmonary artery was anastomosed to the main pulmonary artery with a running suture. The girl recovered well. Echocardiographic examination during an outpatient visit 3 months post-ASO showed following images on a skewed parasternal long-axis view (figure 1A) and high …

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    Footnotes

    • Contributors Drafting of the manuscript: IvB and RLFvdP. Acquisition of the images: RLFvdP and LJMK. Critical revision of the manuscript: all authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.