3D geometry of coronary arteries after arterial switch operation for transposition of the great arteries and late coronary events

Structured abstract Objective Using 3D modeling to predict late coronary events after the arterial switch operation (ASO) for TGA. Method We reviewed 100 coronary CT performed after ASO randomly selected from free-from-coronary-event patients and 21coronary CT from patients who had a coronary event later than 3 years after ASO. Using 3D modeling software, we defined and measured 6 geometric criteria for each coronary artery: Clockwise position of coronary ostium, First centimeter angle defined as the angle between of the coronary artery ostium and the first centimeter of the vessel, Minimal 3 D angle between the coronary first centimeter and the aortic wall, Ostium height defined as the distance between the ostium and the aortic valve, Distance between the coronary ostium and the pulmonary artery, and Distance between the coronary first centimeter and the pulmonary artery. Results None of the right ostium geometric parameters was associated with coronary events. Four/6 criteria of left coronary artery geometry were associated to coronary events: Clockwise position of the left ostium > 67° (p 62°, p 62° and minimal angle in 3D Conclusion The acquired geometric characteristics of the transferred left coronary artery are associated with coronary events. Imaging coronary arteries after ASO might be useful to select patients at higher risk of coronary events and to tailor surveillance.