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Figure 2 Short-axis images of three cases of children after ASO for TGA. Representative apical, midventricular and basal slices are depicted at rest and during adenosine-induced vasodilation. Images are oriented with anterior wall on the top, lateral wall to the right, septum to the left and inferior wall at the bottom. Case A represents a 9-year old after ASO for simple TGA at 7 days after birth without visually detectable regional abnormalities. Quantitative global MBF was 93 ml/100 g/min at rest and 295 ml/100 g/min during adenosine stress; coronary flow reserve was 3.2. In case B, a moderate adenosine-induced reversible abnormality in the basal anterolateral wall was found at visual analysis (arrowhead). This 9-year old also had early ASO for simple TGA at 11 days after birth. Quantitatively, global MBF was 83 ml/ 100 g/min at rest and 241 ml/100 g/min during adenosine stress; coronary flow reserve was 2.9. Case C shows images of a 16-year old patient with TGA and an associated large VSD (arrows). The defect was closed with a patch during ASO and appears on the images as a fixed abnormality in the basal septal wall. This child, who underwent ASO at an age of 5 years, had MBFs of 83 ml/100 g/min at rest and 252 ml/100 g/min during adenosine stress; coronary flow reserve was 3.0. Sectors containing the structural defect were excluded from quantitative flow analysis in this case.
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