Skip to main content
SpringerLink
Log in

Coronary Artery Disease Risk in Patients with Congenital Heart Disease

  • Pediatrics (S Gidding, Section Editor)
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

As the congenital heart disease population ages, coronary artery disease may emerge as a significant comorbidity. This presents a new problem to cardiologists caring for an aging population that did not previously exist. Various congenital heart defects are likely at higher risk for the development of coronary artery disease including congenital coronary artery anomalies, defect with abnormal coronary artery connections to the ventricles, and conotruncal anomalies that require coronary artery reimplantation. The impact of coronary artery disease on this population remains to be seen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gatzoulis MA. Adult congenital heart disease: a cardiovascular area of growth in urgent need of additional resource allocation. Int J Cardiol. 2004;97 suppl 1:1–2.

    Article  PubMed  Google Scholar 

  2. Marelli AJ, Mackie AS, Ionescu-Ittu R, Rahme E, Pilote L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation. 2007;115:163–72.

    Article  PubMed  Google Scholar 

  3. Opotowsky AR, Siddiqi OK, Webb GD. Trends in hospitalizations for adults with congenital heart disease in the U.S. J Am Coll Cardiol. 2009;54:460–7.

    Article  PubMed  Google Scholar 

  4. Baraona F, Valente AM, Porayette P, Pluchinotta FR, Sanders SP. Coronary arteries in childhood heart disease: implications for management of young adults. J Clin Exp Cardiolog. 2012 Jun 15;(Suppl 8). pii: 006.

  5. Lowry AW, Olabiyi OO, Adachi I, Moodie DS, Knudson JD. Coronary artery anatomy in congenital heart disease. Congenit Heart Dis. 2013;8:187–202.

    Article  PubMed  Google Scholar 

  6. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Catheter Cardiovasc Diagn. 1990;21:28–40.

    Article  CAS  Google Scholar 

  7. Musiani A, Cernigliaro C, Sansa M, Maselli D, De Gasperis C. Left main coronary artery atresia: literature review and therapeutical considerations. Eur J Cardiothorac Surg. 1997;11:505–14.

    Article  CAS  PubMed  Google Scholar 

  8. Wittlieb-Weber CA, Paridon SM, Gaynor JW, Spray TL, Weber DR, Brothers JA. Medium-term outcome after anomalous aortic origin of a coronary artery repair in a pediatric cohort. J Thorac Cardiovasc Surg. 2013. doi:10.1016/j.jtcvs.2013.07.022.

    PubMed  Google Scholar 

  9. Calder AL, Co EE, Sage MD. Coronary arterial abnormalities in pulmonary atresia with intact ventricular septum. Am J Cardiol. 1987;59:436–42.

    Article  CAS  PubMed  Google Scholar 

  10. Giglia TM, Mandell VS, Connor AR, Mayer Jr JE, Lock JE. Diagnosis and management of right ventricle-dependent coronary circulation in pulmonary atresia with intact ventricular septum. Circulation. 1992;86:1516–28.

    Article  CAS  PubMed  Google Scholar 

  11. Daubeney PE, Delany DJ, Anderson RH, Sandor GG, Slavik Z, et al. Pulmonary atresia with intact ventricular septum: range of morphology in a population-based study. J Am Coll Cardiol. 2002;39:1670–9.

    Article  PubMed  Google Scholar 

  12. Hanley FL, Sade RM, Blackstone EH, Kirklin JW, Freedom RM, Nanda NC. Outcomes in neonatal pulmonary atresia with intact ventricular septum. A multiinstitutional study. J Thorac Cardiovasc Surg. 1993;105:406–23.

    CAS  PubMed  Google Scholar 

  13. O'Connor WN, Cottrill CM, Johnson GL, Noonan JA, Todd EP. Pulmonary atresia with intact ventricular septum and ventriculocoronary communications: surgical significance. Circulation. 1982;65:805–9.

    Article  PubMed  Google Scholar 

  14. Guleserian KJ, Armsby LB, Thiagarajan RR, del Nido PJ, Mayer Jr JE. Natural history of pulmonary atresia with intact ventricular septum and right-ventricle-dependent coronary circulation managed by the single-ventricle approach. Ann Thorac Surg. 2006;81:2250–7.

    Article  PubMed  Google Scholar 

  15. Nathan M, Williamson AK, Mayer JE, Bacha EA, Juraszek AL. Mortality in hypoplastic left heart syndrome: review of 216 autopsy cases of aortic atresia with attention to coronary artery disease. J Thorac Cardiovasc Surg. 2012;144:1301–6.

    Article  PubMed  Google Scholar 

  16. Jonas RA, Hansen DD, Cook N, Wessel D. Anatomic subtype and survival after reconstructive operation for hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 1994;107:1121–7.

    CAS  PubMed  Google Scholar 

  17. Vida VL, Bacha EA, Larrazabal A, Gauvreau K, Dorfman AL, Marx G, et al. Surgical outcome for patients with the mitral stenosis-aortic atresia variant of hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 2008;135:339–46.

    Article  PubMed  Google Scholar 

  18. Sathanandam S, Cui W, Nguyen NV, Husayni TS, Van Bergen AH, Sajan I, et al. Ventriculocoronary artery connections with the hypoplastic left heart: a 4-year prospective study: incidence, echocardiographic and clinical features. Pediatr Cardiol. 2010;31:1176–85.

    Article  PubMed  Google Scholar 

  19. Ghanayem NS, Allen KR, Tabbutt S, Atz AM, Clabby ML, Cooper DS, et al. Pediatric Heart Network Investigators. Interstage mortality after the Norwood procedure: Results of the multicenter Single Ventricle Reconstruction trial. J Thorac Cardiovasc Surg. 2012;144:896–906.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Stoica SC, Philips AB, Egan M, Rodeman R, Chisolm J, Hill S, et al. Ann Thorac Surg. 2009;88:1939–46.

    Article  PubMed  Google Scholar 

  21. Need LR, Powell AJ, del Nido P, Geva T. Coronary echocardiography in tetralogy of Fallot: diagnostic accuracy, resource utilization and surgical implications over 13 years. J Am Coll Cardiol. 2000;36:1371–7.

    Article  CAS  PubMed  Google Scholar 

  22. Fraisse A, Assaidi A, Mauri L, Malekzadeh-Milani S, Thambo JB, Bonnet D, et al. Coronary artery compression during intention to treat right ventricle outflow with percutaneous pulmonary valve implantation: Incidence, diagnosis and outcome. Catheter Cardiovasc Interv. 2014. doi:10.1002/ccd.25471.

    PubMed  Google Scholar 

  23. Lenox CC, Debich DE, Zuberbuhler JR. The role of coronary artery abnormalities in the prognosis of truncus arteriosus. J Thorac Cardiovasc Surg. 1992;104(6):1728–42.

    CAS  PubMed  Google Scholar 

  24. Wernovsky G, Sanders SP. Coronary artery anatomy and transposition of the great arteries. Coron Artery Dis. 1993;4:148–57.

    Article  CAS  PubMed  Google Scholar 

  25. Pasquali SK, Hasselblad V, Li JS, Kong DF, Sanders SP. Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation. 2002;106:2575–80.

    Article  PubMed  Google Scholar 

  26. Tanel RE, Wernovsky G, Landzberg MJ, Perry SB, Burke RP. Coronary artery abnormalities detected at cardiac catheterization following the arterial switch operation for transposition of the great arteries. Am J Cardiol. 1995;76:153–7.

    Article  CAS  PubMed  Google Scholar 

  27. Legendre A, Losay J, Touchot-Kone A, Serraf A, Belli E, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation. 2003;108:186–90.

    Article  Google Scholar 

  28. Nikaidoh H. Aortic translocation and biventricular outflow tract reconstruction. A new surgical repair for transposition of the great arteries associated with ventricular septal defect and pulmonary stenosis. J Thorac Cardiovasc Surg. 1984;88:365–72.

    CAS  PubMed  Google Scholar 

  29. Ross DN. Aortic root replacement with a pulmonary autograft—current trends. J Heart Valve Dis. 1994;3:358–60.

    CAS  PubMed  Google Scholar 

  30. Pedra SR, Pedra CA, Abizaid AA, Braga SL, Staico R, Arrieta R, et al. Intracoronary ultrasound assessment late after the arterial switch operation for transposition of the great arteries. J Am Coll Cardiol. 2005;21(45):2061–8.

    Article  Google Scholar 

  31. Gagliardi MG, Adorisio T, Crea F, Versacci P, DiDonato R, Sanders SP. Abnormal vasomotion function of the epicardial coronary arteries in children five to eight years after arterial switch operation: an angiographic and intracoronary Doppler flow wire study. J Am Coll Cardiol. 2005;46:1565–72.

    Article  PubMed  Google Scholar 

  32. Khairy P, Clair M, Fernandes SM, Blume ED, Powell AJ, Newburger JW, et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation. 2013;127:331–9.

    Article  PubMed  Google Scholar 

  33. Pasquali SK, Marino BS, Pudusseri A, Wernovsky G, Paridon SM, Walker SA, et al. Risk factors and comorbidities associated with obesity in children and adolescents after the arterial switch operation and Ross procedure. Am Heart J. 2009;158:473–9.

    Article  PubMed  Google Scholar 

  34. Perloff JK. Cyanotic congenital heart disease: The coronary arterial circulation. Curr Cardiol Rev. 2012;8:1–5.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Guerri-Guttenberg RA, Castilla R, Francos GC, Müller A, Ambrosio G, Milei J. Transforming Growth Factor b1 and Coronary Intimal Hyperplasia in Pediatric Patients With Congenital Heart Disease. Can J Cardiol. 2013;29:849–57.

    Article  PubMed  Google Scholar 

  36. Giannakoulas G, Dimopoulos K, Engel R, Goktekin O, Kucukdurmaz Z, Vatankulu MA, et al. Burden of coronary artery disease in adults with congenital heart disease and its relation to congenital and traditional heart risk factors. Am J Cardiol. 2009;103:1445–50.

    Article  PubMed  Google Scholar 

  37. Yalonetsky S, Horlick EM, Osten MD, Benson LN, Oechslin EN, Silversides CK. Clinical characteristics of coronary artery disease in adults with congenital heart defects. Int J Cardiol. 2013;164:217–20.

    Article  PubMed  Google Scholar 

  38. Tutarel O, Kempny A, Alonso-Gonzalez R, Jabbour R, Li W, Uebing A, et al. Congenital heart disease beyond the age of 60: emergence of a new population with high resource utilication, high morbidity and high mortality. Eur Heart J. 2013. doi:10.1093/eurheartj/eht257.

    PubMed  Google Scholar 

  39. Afilalo J, Therrien J, Pilote L, Ionescu-Ittu R, Martucci G, Marelli AJ. Geriatric congenital heart disease: burden of disease and predictors of mortality. J Am Coll Cardiol. 2011;58:1509–15.

    Article  PubMed  Google Scholar 

  40. Roche SL, Silversides CK. Hypertension, obesity, and coronary artery disease in the survivors of congenital heart disease. Can J Cardiol. 2013;29:841–8.

    Article  PubMed  Google Scholar 

  41. Stulak JM, Dearani JA, Burkhart HM, Ammash NM, Phillips SD, Schaff HV. Coronary artery disease in adult congenital heart disease: Outcome after coronary artery bypass grafting. Ann Thorac Surg. 2012;93:116–23.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Meryl Cohen is a board member for the American Society of Echocardiography. Dr. Cohen received a grant from NIH PHN, received travel compensation for speaking engagements, and received honoraria as a Grand Rounds speaker at NYU.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA

    Meryl S. Cohen

Authors
  1. Meryl S. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Meryl S. Cohen.

Additional information

This article is part of the Topical Collection on Pediatrics

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cohen, M.S. Coronary Artery Disease Risk in Patients with Congenital Heart Disease. Curr Cardiovasc Risk Rep 8, 391 (2014). https://doi.org/10.1007/s12170-014-0391-8

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s12170-014-0391-8

Keywords

Search

Navigation