title: Double switch operation in cardiac anomalies with atrioventricular and ventriculoarterial discordance.
abstract: Since June 1987, 10 of 19 consecutive patients with atrioventricular and ventriculoarterial discordance (average age 4 +/- 2 years) had undergone a double switch operation with the morphologically left ventricle used as a systemic ventricle. There were two combinations of procedures. Atrial switch combined with arterial switch was used in two patients who had a normal pulmonary valve. Atrial switch combined with ventriculoarterial switch by Rastelli's procedure was used in eight patients with pulmonary stenosis or atresia and a large ventricular septal defect. One early death and two late deaths have occurred in a postoperative follow-up period of up to 4 years. Subsequent problems were mainly related to the results of atrial switch procedures in patients who had a small atrium because of low pulmonary flow, especially in patients with apicocaval juxtaposition. Our experience suggested that the double switch operation would open a new era of definitive surgical treatment in half of the patients with atrioventricular and ventriculoarterial discordance.
authors.affiliation: Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yagihara
authors.forename: H
authors.initials: H
authors.lastname: Kishimoto
authors.forename: F
authors.initials: F
authors.lastname: Isobe
authors.forename: F
authors.initials: F
authors.lastname: Yamamoto
authors.forename: K
authors.initials: K
authors.lastname: Nishigaki
authors.forename: O
authors.initials: O
authors.lastname: Matsuki
authors.forename: H
authors.initials: H
authors.lastname: Uemura
authors.forename: T
authors.initials: T
authors.lastname: Kamiya
authors.forename: Y
authors.initials: Y
authors.lastname: Kawashima
mesh_terms: D001011:Aorta / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006325:Heart Atria / Q000002:abnormalities* / Q000601:surgery; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery*; D016896:Treatment Outcome