Coronary Events and Anatomy After Arterial Switch Operation for Transposition of the Great Arteries: Detection by 16-Row Multislice Computed Tomography Angiography in Pediatric Patients

The purpose of this study was to evaluate the feasibility of multislice computed tomographic (MSCT) angiography as a noninvasive method for detecting ostial, proximal, and middle segment coronary stenosis or occlusion and anatomy in patients with transposition of the great arteries who had undergone arterial switch operation (ASO). Sixteen-detector-row MSCT angiography was performed in 16 patients treated with ASO for transposition of the great arteries. The median age was 10.3 years (range, 6.2-16.3 years). Sixteen-detector-row MSCT angiography was performed in 16 patients who had undergone ASO. CT imaging was performed in the craniocaudal direction from 2 cm above the carina up to the heart basis. Noninvasive assessment of coronary artery stenosis and anatomy were investigated by MSCT angiography. Two patients were excluded from the study because of artifacts. Of 14 evaluated patients, 1 patient had ostial stenosis (7.1%). A coronary artery anatomy variant was present in six patients: left main artery (LMA) and right coronary artery (RCA) originating from the right sinus as a single orifice (n = 2); left circumflex artery (LCX) originating from the RCA (n = 1); LMA and RCA, after branching to the LCX, originating separately from the right sinus (n = 1); and LMA (n = 1) and left anterior descending artery (LADA; n = 1) originating directly from the right sinus. Intramural bridging in the LAD (n = 2) was detected. Five patients were normal. In conclusion, MSCT angiography, as a noninvasive, feasible technique for assessing coronary stenosis or occlusion and anatomy, can be used in the follow-up of patients who have undergone ASO

MED-CORDEX initiative for Mediterranean Climate studies

Since the early' 90s, a number of research projects have focused on downscaling global climate simulations over the Euro-Mediterranean region. The Mediterranean region is considered as particularly sensitive and vulnerable to climate variability and change, in particular, because of its vulnerability to changes in the water cycle. The Mediterranean basin has a quite unique character resulting from both orographic conditions and demographic trends. The region features an enclosed sea, which is connected to the Atlantic ocean only by Gibraltar strait, surrounded by highly urbanized littorals and complex topography and coaslines, from which numerous rivers feed the Mediterranean sea. This results in many interactions and feedbacks across ocean-atmosphere-land processes that play a prominent role in determining the Mediterranean climate and, in turn, its impact on natural ecosystems and human activities. Therefore, MedCORDEX deals with a unique region where downscaling of global climate simulations needs to consider both, high fine scale forcings and the interactions across different components of the regional earth system (atmosphere, ocean, rivers, aerosols etc.). In order to describe the main features of MED-CORDEX, ehre we present illustrative examples from the first inter-comparison of several coupled and un-coupled regional simulations of present day climate over the MED-CORDEX domain. Relevant atmospheric and oceanic processes have been analyzed to provide an evaluation of the skill of Regional Climate System Models for the Mediterranean region.JRC.D.2-Water and Marine Resource