Early branching of the left coronary artery (LCA) may become an additional operative
challenge during coronary transfer in anatomic correction of transposition of the
great arteries. An early branch of the LCA running in opposite transfer direction
was present in 3 out of 25 patients who underwent anatomic correction. By excising
a large cuff of aortic sinus wall around the ostium of the LCA enough length was gained
for successful coronary transfer without kinking in 2 patients in whom the first branch
was arising at the level of the origin of the circumflex artery. In the third patient
with the first branch arising proximal to the origin of the circumflex artery an alternative
surgical procedure seemed preferable. In such a coronary anomaly optimal visualization
of the coronary branching pattern, possibly including selective coronary angiography,
is advisable for better planning of the surgical technique.
Transposition of the great arteries - Coronary transfer - Early branching of the left
coronary artery
