THE CORONARY CIRCULATION IN COMPLETE TRANSPOSITION OF THE GREAT VESSELS

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Abstract
Seven cases of complete transposition of the great vessels were seen at Guy''s Hospital, in each of which the anatomical diagnosis was confirmed by autopsy. Absent left circumflex artery was found in 2, dilatation of the coronary arteries in 4, myocardial fibrosis, mainly affecting the right ventricle in 4, and endocardial fibro-elastosis in 2 cases. The embryology and anatomy of the coronary arteries in complete transposition of the great vessels is discussed. The etiology of myocardial ischemia in this condition is thought to be due to discrepancy between the myocardial demand for blood and the coronary blood supply. When this discrepancy is acute, myocardial infarction may occur; and when it is gradual, progressive myocardial fibrosis may develop.