Staged approach for congenitally corrected transposition of the great arteries associated with dextrocardia and nonconfluent pulmonary artery.
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.
Department of Cardiovascular Surgery, Chiba Children's Hospital, Chiba, Japan. agematsuagain@yahoo.co.jp
Kouta
K
Agematsu
Mitsuru
M
Aoki
Yuuji
Y
Naitou
Tadasi
T
Fujiwara
D000015:Abnormalities, Multiple; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D003914:Dextrocardia / Q000601:surgery*; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities*; D054079:Vascular Malformations / Q000601:surgery*