Successful Trapdoor Technique for Two Separate Coronary Ostia in a Single Aortic Sinus in Arterial Switch Operation for Complete Transposition of the Great Arteries

Two separate origins of coronary arteries from a single aortic sinus remains a rare but significant congenital anomaly for surgical repair. We experienced a case of a newborn with complete transposition of the great arteries with unusual coronary arteries with two separate ostia positioned close to each other in the same right aortic sinus, and the left coronary artery coursing behind the pulmonary artery. No description of this case in the English literature has been published to our knowledge. Precise anatomical diagnosis was made at operation, and these anomalous coronaries were successfully transferred by the trapdoor technique with delicate adjustment after transfer. Postoperative catheterization and angiogram done 14 months after the arterial switch operation showed no coronary artery stenosis along with normal chamber pressures. The infant is asymptomatic and shows normal development for his age.