Transfer of Coronary Ostia by “Triangulation” in Transposition of the Great Vessels and Anomalous Coronary Arteries

1.The surface anatomy of the coronary arteries in transposition of the great vessels and of anomalous coronary arteries has been reviewed.2.Based on this surface anatomy, operative maneuvers for correction of the outflow tract in transpositions with or without aberrant coronary arteries have been described as they were developed in the experimental laboratory and on fresh necropsy specimens.3.A similar operative procedure, involving “triangulation” of the sinus of Valsalva, has been described for correcting anomalous coronary artery occurring in the absence of the transposition defect.4.On the basis of these studies, triangulation of the sinus of Valsalva seems technically feasible and permits transfer of the coronary ostia from one outflow tract to the other without significant rotation of the main trunks of the coronary arteries and without damage to the aortic or pulmonary valves.