AI Article Synopsis

  • The surgical technique discussed involves a half-turned truncal switch operation used in a 5-year-old with complex heart conditions, including D-TGA and a ventricular septal defect.
  • This procedure aims to improve blood flow dynamics by creating better biventricular outflow tracts.
  • It utilizes the patient's own pulmonary valve for the right ventricular outflow, reducing the need for an artificial conduit.

Article Abstract

We describe a surgical technique for a half-turned truncal switch operation in a 5-year-old child with dextro-transposition of the great arteries (D-TGA), a ventricular septal defect, a left ventricular outflow tract obstruction and a complex coronary pattern. The benefit of the half-turned truncal switch is the creation of haemodynamically superior biventricular outflow tracts and the maximal use of an autologous pulmonary valve in the right ventricular outflow tract, thereby avoiding the right ventricular-pulmonary artery conduit.

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http://dx.doi.org/10.1510/mmcts.2024.037DOI Listing

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Congenitally corrected transposition of the great arteries (ccTGA) is an infrequent and complex congenital malformation, which accounts for approximately 0.5% of all congenital heart defects. This defect is characterized by both atrioventricular and ventriculoarterial discordance, with the right atrium connected to the morphological left ventricle (LV), ejecting blood into the pulmonary artery, while the left atrium is connected to the morphological right ventricle (RV), ejecting blood into the aorta.

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Article Synopsis
  • The surgical technique discussed involves a half-turned truncal switch operation used in a 5-year-old with complex heart conditions, including D-TGA and a ventricular septal defect.
  • This procedure aims to improve blood flow dynamics by creating better biventricular outflow tracts.
  • It utilizes the patient's own pulmonary valve for the right ventricular outflow, reducing the need for an artificial conduit.
View Article and Find Full Text PDF

Repair of complex transposition of great arteries: What is the best technique to avoid outflow tract obstructions?

Eur J Cardiothorac Surg

March 2024

Department of Congenital Heart Surgery-Pediatric Heart Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany.

Objectives: This study aimed to evaluate the short-/mid-term outcome of patients with complex dextro (d)-/levo (l)-transposition of the great arteries (TGA), ventricular septal defect and left ventricular outflow tract obstructions.

Methods: A single-centre, retrospective review of all complex dextro-TGA (n = 85) and levo-TGA (n = 22) patients undergoing different surgeries [Arterial switch operation + left ventricular outflow tract obstruction-resection (ASO-R), half-turned truncal switch/Mair (HTTS), Nikaidoh and Rastelli] between May 1990 and September 2022 was performed. Groups were analysed using Kruskal-Wallis test with post hoc pairwise comparison and Kaplan-Meier time-to-event models.

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Objectives: The en-bloc rotation of the outflow tracts (EBR) enables an anatomic correction of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction. The anatomical condition or previous palliative procedures may allow choosing an elective date for the anatomic correction. The aim of this study was to evaluate the optimal age for performing the EBR based on the largest series published so far.

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