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Staged Approach for Congenitally Corrected Transposition of the Great Arteries Associated with Dextrocardia and Nonconfluent Pulmonary Artery
Author(s) -
Agematsu Kouta,
Aoki Mitsuru,
Naitou Yuuji,
Fujiwara Tadasi
Publication year - 2009
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2009.00832.x
Subject(s) - dextrocardia , medicine , great arteries , transposition (logic) , pulmonary artery , cardiology , corrected transposition , heart disease , linguistics , philosophy
We completed double switch operation (Senning plus Rastelli procedure; SLL) after staged palliative operations for SLL, dextrocardia, congenitally corrected transposition of the great arteries ventricular septal defect, atrial septal defect, and nonconfluent pulmonary artery. The patient had undergone three preparatory operations including central pulmonary artery reconstruction with autologous pericardium and morphologic right ventricle‐pulmonary artery shunt and then double switch operation was performed. During the double switch operation, the previous conduit which was established as right ventricle‐pulmonary artery shunt in the third palliation was replaced by a larger conduit. This conduit was used as Rastelli external conduit to avoid coronary artery injury. When systemic venous chamber was reconstructed, suture line pouch technique was used, in which dog ears were made at the sites of superior and inferior vena cava orifices, respectively, to prevent systemic venous return obstruction. Pulmonary venous chamber was reconstructed without any augmentation, which reduced the possibility of postoperative arrhythmia. Systemic and pulmonary venous pathway obstructions were not observed after the operation. Postoperative arrhythmia was not detected.