Coronary artery distribution for D-transposition of the great arteries

Coronary artery distribution in TGA.
(Upper panels) Diagnostic projection; diagram of the origin and proximal course as visualized by two-dimensional echocardiography and caudally angulated aortography (see text).
(Lower panels) Same coronary artery distribution as viewed anteriorly (surgeon's view, frontal projection). Note that the circumflex coronary artery, or even the entire left coronary artery system, is more likely to pursue a retropulmonary course (dashed lines) when the great arteries are in a side-by-side relationship (shown). An intramural course (shaded) of the proximal coronary artery exists in <3 percent of cases but has been associated with higher risk for transfer during an arterial switch operation. Alternative terminology in brackets is shown as popularized by Quagebeur and Kirklin and the Congenital Heart Surgeons Society.