Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-28T14:49:17.617Z Has data issue: false hasContentIssue false
  • English
  • Français

Coronary artery spasm in a neonate with transposition of great arteries: a rare complication and reason for heart transplant

Published online by Cambridge University Press:  08 August 2017

Neha Bansal ,
Ralph E. Delius  and
Sanjeev Aggarwal
Neha Bansal*
Affiliation:
Division of Cardiology, The Carmen and Ann Adams Department of Pediatrics, Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, United States of America
Ralph E. Delius
Affiliation:
Division of Cardiovascular Surgery, Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, United States of America
Sanjeev Aggarwal
Affiliation:
Division of Cardiology, The Carmen and Ann Adams Department of Pediatrics, Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, United States of America
*
Correspondence to: N. Bansal, Division of Pediatric Cardiology, The Children’s Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201, United States of America. Tel: 313 745 5481; Fax: 313 993 0894. E-mail: nehban@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Arterial switch operation has become the standard of care for d-transposition of great arteries and has excellent short- and long-term outcomes. We report the case of a newborn with a diagnosis of d-transposition of great arteries with intact ventricular septum and a low-risk coronary artery anatomy who developed coronary artery vasospasm while coming off bypass following arterial switch operation in the operating room. The coronary artery spasm led to severe biventricular dysfunction and need for extracorporeal membranous oxygenation support. Despite extracorporeal membranous oxygenation and inotropic support, there was no improvement in the left ventricular function, and cardiac transplantation was performed after 8 days. The explanted heart showed extensive infarction of both ventricles. Both the coronary ostei were patent with no evidence of thrombus, suggesting coronary artery vasospasm rather than embolus or thrombus formation. This is the first case of coronary artery vasospasm in a neonate with d-transposition of great arteries leading to cardiac transplantation. We speculate that early identification of patients who are at a high risk for coronary vasospasm and prophylactic or timely infusion of papaverine directly into the coronary arteries may be beneficial in this condition.

Keywords

Transposition of great vesselscardiac transplantationnewborn
Type
Brief Report
Information
Cardiology in the Young , Volume 28 , Issue 1 , January 2018 , pp. 163 - 167
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Brown, JW, Park, HJ, Turrentine, MW. Arterial switch operation: factors impacting survival in the current era. Ann Thorac Surg 2001; 71: 1978–1984.CrossRefGoogle ScholarPubMed
2. Metton, O, Calvaruso, D, Gaudin, R, et al. Intramural coronary arteries and outcome of neonatal arterial switch operation. Eur J Cardiothorac Surg 2010; 37: 1246–1253.CrossRefGoogle ScholarPubMed
3. Castaneda, AR, Trusler, GA, Paul, MH, Blackstone, EH, Kirklin, JW. The early results of treatment of simple transposition in the current era. J Thorac Cardiovasc Surg 1988; 95: 14–28.CrossRefGoogle ScholarPubMed
4. Jatene, AD, Fontes, VF, Paulista, PP, et al. Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg 1976; 72: 364–370.CrossRefGoogle ScholarPubMed
5. Lecompte, Y, Zannini, L, Hazan, E, et al. Anatomic correction of transposition of the great arteries. J Thorac Cardiovasc Surg 1981; 82: 629–631.CrossRefGoogle ScholarPubMed
6. Blume, ED, Altmann, K, Mayer, JE, Colan, SD, Gauvreau, K, Geva, T. Evolution of risk factors influencing early mortality of the arterial switch operation. J Am Coll Cardiol 1999; 33: 1702–1709.CrossRefGoogle ScholarPubMed
7. Kirklin, JW, Blackstone, EH, Tchervenkov, CI, Castaneda, AR. Clinical outcomes after the arterial switch operation for transposition. Patient, support, procedural, and institutional risk factors. Congenital Heart Surgeons Society. Circulation 1992; 86: 1501–1515.CrossRefGoogle ScholarPubMed
8. Khairy, P, Clair, M, Fernandes, SM, et al. Cardiovascular outcomes after the arterial switch operation for d-transposition of the great arteries. Circulation 2013; 127: 331–339.CrossRefGoogle ScholarPubMed
9. Qamar, ZA, Goldberg, CS, Devaney, EJ, Bove, EL, Ohye, RG. Current risk factors and outcomes for the arterial switch operation. Ann Thorac Surg 2007; 84: 871–878; discussion 8–9.CrossRefGoogle ScholarPubMed
10. Bacha, EA, Quinones, J, Kahana, MD, Baron, JM, Hijazi, ZM. Embolic coronary occlusion after the arterial switch procedure. J Thorac Cardiovasc Surg 2001; 122: 1028–1030.CrossRefGoogle ScholarPubMed
11. Prinzmetal, M, Kennamer, R, Merliss, R, Wada, T, Bor, N. Angina pectoris. I. A variant form of angina pectoris; preliminary report. Am J Med 1959; 27: 375–388.CrossRefGoogle Scholar
12. Jefferies, JL, Treistman, B. Prinzmetal angina in a teenage girl. Pediatr Cardiol 2005; 26: 486–487.CrossRefGoogle Scholar
13. Ivy, D, Kaye, J, Flitter, D, Wiggins, J. Variant angina in an adolescent. Pediatr Cardiol 1994; 15: 45–47.CrossRefGoogle Scholar
14. Basnet, S, Mander, G, Nicolas, R. Coronary vasospasm in an adolescent resulting from marijuana use. Pediatr Cardiol 2009; 30: 543–545.CrossRefGoogle Scholar
15. Parent, B, Wearden, P, Kounis, NG, Chrysostomou, C. Kounis syndrome or allergic coronary vasospasm in a two-year-old. Congenit Heart Dis 2011; 6: 499–503.CrossRefGoogle ScholarPubMed
16. Jasmin, R, Ng, CT, Sockalingam, S, Yahya, F, Cheah, TE, Sadiq, MA. Myocardial infarction with normal coronaries: an unexpected finding in a 13-year-old girl with systemic lupus erythematosus. Lupus 2013; 22: 1518–1522.CrossRefGoogle Scholar
17. Tsuda, E, Yasuda, T, Naito, H. Vasospastic angina in Kawasaki disease. J Cardiol 2008; 51: 65–69.CrossRefGoogle ScholarPubMed
18. Dalzell, JR, Jackson, CE, Petrie, MC, Hogg, KJ. Acute myocardial infarction due to coronary vasospasm in a heart transplant recipient. Am J Emerg Med 2010; 28: 539 e1-4.CrossRefGoogle Scholar
19. Ferguson, DW, Farwell, AP, Bradley, WA, Rollings, RC. Coronary artery vasospasm complicating acute myocarditis. A rare association. West J Med 1988; 148: 664–669.Google ScholarPubMed
20. Kobayashi, K, Kouzuma, R, Tsutsui, M, Okazaki, M, Tasaki, H, Nakashima, Y. Vasospastic angina in a 16-year-old female. Circulation 2003; 67: 467–469.CrossRefGoogle ScholarPubMed
21. Yoshimura, M, Yasue, H, Nakayama, M, et al. Genetic risk factors for coronary artery spasm: significance of endothelial nitric oxide synthase gene T-786-->C and missense Glu298Asp variants. J Investig Med 2000; 48: 367–374.Google ScholarPubMed
22. Kawata, M, Mizutani, T, Shimizu, M, et al. Endothelial nitric oxide synthase gene mutation and human leukocyte antigen analyzed in three cases of familial vasospastic angina pectoris. Jpn Circ J 2000; 64: 524–527.CrossRefGoogle ScholarPubMed