Coronary artery occlusion after arterial switch operation in an asymptomatic 15-year-old boy

Figure 1 Conventional and computer tomographic coronary angiogram in a 15-year-old patient with infero-lateral ST segment changes on exercise stress test following arterial switch operation for complete transposition of the great arteries. Aortic root injection at catheterization demonstrates retrograde filling of the completely occluded LMCA from ample collaterals vessels from the right (A). CT angiographic views of the antero-posterior (B), left anterior oblique (C) and coronary views (D) indicates ostial occlusion and hypoplasia of the LMCA with collateralization from at the enlarged right coronary artery. CT: Computed tomogram; LMCA: Left main coronary artery.