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Case report
peer-reviewed

A Rare Case of Coronary Artery Embolism in a Patient with d-Transposition of the Great Arteries with Prior Mustard Repair



Abstract

The dextro-transposition of great arteries (d-TGA) is a rare, congenital, cyanotic heart disease and there is a paucity of data regarding long-term cardiovascular outcomes. We present a rare case of non-ST-elevation myocardial infarction (NSTEMI) in a patient with surgically repaired d-TGA. A 43-year-old male who had previously undergone a Mustard atrial switch palliative procedure presented with chest pain and diaphoresis and was diagnosed with NSTEMI. A coronary angiogram revealed a small, underdeveloped, left anterior descending and a large, left circumflex coronary artery with an acute embolic lesion. The embolic lesion was secondary to atrial fibrillation and was successfully treated with aspiration thrombectomy. This case highlights the variations in coronary anatomy in surgically repaired d-TGA and the importance of recognizing the potential for long-term complications in these cases.



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Case report
peer-reviewed

A Rare Case of Coronary Artery Embolism in a Patient with d-Transposition of the Great Arteries with Prior Mustard Repair


Author Information

Prince Sethi Corresponding Author

Cardiology/internal Medicine, University of South Dakota Sanford School of Medicine

Udit Bhatnagar

Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center

Kelly Steffen

Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center

Edgard Bendaly

Pediatric Cardiology, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center

Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center

Adam Stys

Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Acknowledgements

We thank Dr. Dennis Stevens for his technical assistance in the preparation of this manuscript.


Case report
peer-reviewed

A Rare Case of Coronary Artery Embolism in a Patient with d-Transposition of the Great Arteries with Prior Mustard Repair


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Case report
peer-reviewed

A Rare Case of Coronary Artery Embolism in a Patient with d-Transposition of the Great Arteries with Prior Mustard Repair

  • Author Information
    Prince Sethi Corresponding Author

    Cardiology/internal Medicine, University of South Dakota Sanford School of Medicine

    Udit Bhatnagar

    Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center

    Kelly Steffen

    Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center

    Edgard Bendaly

    Pediatric Cardiology, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center

    Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center

    Adam Stys

    Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sanford Usd Medical Center


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements

    We thank Dr. Dennis Stevens for his technical assistance in the preparation of this manuscript.


    Article Information

    Published: February 12, 2018

    DOI

    10.7759/cureus.2183

    Cite this article as:

    Sethi P, Bhatnagar U, Steffen K, et al. (February 12, 2018) A Rare Case of Coronary Artery Embolism in a Patient with d-Transposition of the Great Arteries with Prior Mustard Repair. Cureus 10(2): e2183. doi:10.7759/cureus.2183

    Publication history

    Received by Cureus: February 06, 2018
    Peer review began: February 07, 2018
    Peer review concluded: February 09, 2018
    Published: February 12, 2018

    Copyright

    © Copyright 2018
    Sethi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The dextro-transposition of great arteries (d-TGA) is a rare, congenital, cyanotic heart disease and there is a paucity of data regarding long-term cardiovascular outcomes. We present a rare case of non-ST-elevation myocardial infarction (NSTEMI) in a patient with surgically repaired d-TGA. A 43-year-old male who had previously undergone a Mustard atrial switch palliative procedure presented with chest pain and diaphoresis and was diagnosed with NSTEMI. A coronary angiogram revealed a small, underdeveloped, left anterior descending and a large, left circumflex coronary artery with an acute embolic lesion. The embolic lesion was secondary to atrial fibrillation and was successfully treated with aspiration thrombectomy. This case highlights the variations in coronary anatomy in surgically repaired d-TGA and the importance of recognizing the potential for long-term complications in these cases.



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