J Cardiovasc Imaging.  2021 Jan;29(1):1-19. 10.4250/jcvi.2020.0106.

Role of Computed Tomography in Postoperative Follow-up of Arterial Switch Operation

Affiliations
  • 1Department of Radiodiagnosis & Imaging, Fortis Escort Heart Institute, New Delhi, India
  • 2Cardiac Imaging, Cardiological Society of India, Kolkata, India
  • 3International Regional Committee, India Chapter, Society of Cardiovascular Computed Tomography, Arlington, VA, USA

Abstract

An arterial switch operation (ASO) is the standard treatment for infants and children born with D-loop transposition of the great arteries. During the ASO, the great vessels are transected from the native roots, switched and anastomosed with the opposite roots. This is accompanied by the relocation of the pulmonary artery anterior to the aorta by using the LeCompte maneuver and the translocation of coronary arteries to the neo-aorta. ASO has led to improved overall survival, and postoperative mortality is rare. Despite the improved outcomes, several postoperative sequelae may occur, and therefore patients require longterm follow-up. Computed tomography (CT) has emerged as a robust imaging modality in pre and postoperative evaluation of a variety of congenital heart disorders including ASO. Unlike echocardiography and cardiovascular magnetic resonance, CT is not hindered by a poor acoustic window, metallic devices or the need for sedation or general anesthesia. CT with advanced three-dimensional postprocessing techniques, high pitch scanning, wider detector system, electrocardiogram-dependent modulation and dose-reduction strategies is invaluable in assessing the postoperative complications after ASO.

Keyword

Arterial switch procedure; Atrial switch operation; Atrial switch repair; Jatene procedure; Transposition of great vessels
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