title: The anatomo-pathological findings in Jatene's procedure.
abstract: At present, the most promising technique for correcting transposition of the great arteries is the arterial switch with coronary reimplantation, which is also being used to correct the Taussig-Bing double outlet right ventricle. A study was undertaken in 5 postmortem hearts from 11 patients aged from 2 to 17 months (average 10.6) who underwent surgery in Salvador, Brazil, between November 1976 and October 1980. Four of these patients died during surgery and 1 soon after. The anatomical diagnoses were transposition of the great arteries in 4 and double outlet right ventricle in 1. The anatomy of each heart was carefully studied, revealing some outstanding aspects: the interatrial septum was intact in 1 case, there was a patent foramem ovale in 2, an atrial septal defect created by atrioseptostomy in 1, and a single atrium in 1; the interventricular septum was intact in 2 cases, a ventricular septal defect of the membranous and muscular type was found in 1 and an atrioventricular canal type in 2; a ventriculotomy (40 mm) for closing a ventricular septal defect was seen in 2 cases; a shortened aortic stump was found in 3 cases and in 1 of these it had been necessary to interpose a dacron conduit between this stump and the pulmonary artery segment; a shortened pulmonary artery stump was seen in 3 cases; the caliber of the pulmonary artery stump had been reduced by 10 mm in 1 of the cases to facilitate anastomosis with the pulmonary artery stump; in 2 cases there was a retraction at the level of the anastomosis between the pulmonary artery stump and the aortic segment due to disproportionate calibers; in 3 cases there was a partial occlusion of the left coronary ostium, and in still another case the right coronary ostium was also partially occluded; displacement of coronary artery ostia from their original sites to new ones ranged from 5 to 13 mm (average 8.5 mm) for the right coronary artery and from 5 to 7 mm (average 6.5 mm) for the left coronary artery; in 1 case the left coronary artery was completely occluded very close to its point of origin, due to torsion and folding.
mesh_terms: D000293:Adolescent; D001011:Aorta / Q000473:pathology; D002675:Child, Preschool; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery; D005260:Female; D006321:Heart / Q000033:anatomy & histology; D006344:Heart Septal Defects, Atrial / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008722:Methods; D009206:Myocardium / Q000473:pathology*; D011651:Pulmonary Artery / Q000473:pathology; D014188:Transposition of Great Vessels / Q000473:pathology* / Q000601:surgery