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  • Title: [Caudal-angle aortography. Its usefulness for defining the coronary anatomy in cases of transposition of the great vessels].
    Author: Sánchez Cortés G, Seguchi M, Momma K.
    Journal: Arch Inst Cardiol Mex; 1992; 62(2):127-32. PubMed ID: 1599330.
    Abstract:
    With the purpose of obtaining an accurate definition of coronary arteries anatomy in complete transposition of the great arteries (concordant atrio-ventricular connection and discordant ventriculo-arterial connection), we performed a new angiographic technique in 14 patients with d-transposition of the great arteries and 1 patient with double-outlet right ventricle. This technique consists of using a balloon catheter with the frontal X ray tube cine-angiographic camera in caudal angulation (about 45 degrees), with balloon occlusion of the ascending aorta during the injection of the contrast medium. The results were compared with echocardiograms and surgical results. In all our cases, except 2, the technique gave us a very clear definition of the coronary anatomy and we were able to define the origin and course of the coronary arteries without difficulty. In the most common coronary artery pattern, the left coronary artery arose from sinus #1 (left aortic sinus) and gave origin to the anterior descending and left circumflex arteries, while the right coronary artery arose from aortic sinus #2 (right aortic sinus). In our series, the coronary arteries always originated from one or both facing sinuses of the aorta and the angiographic correlation with the surgical reports was accurate in all the cases. The anatomical and angiographic findings of this series are discussed. In conclusion, we find the aortogram with caudal angulation a very useful technique to improve the visualization of coronary anatomy in d-transposition of the great arteries, which has surgical significance in those cases which are candidates for anatomical correction.
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