Aortic translocation for the management of double-outlet right ventricle and pulmonary stenosis with dextrocardia: technique to avoid coronary insufficiency.
The management of D-loop transposition of the great arteries with left ventricular outflow tract obstruction and related forms of double-outlet right ventricle is challenging. Association with right ventricular and tricuspid valve hypoplasia and dextrocardia represents a major obstacle to achieve a biventricular repair. The most commonly used technique to deal with this condition, which is the Rastelli operation, further reduces the potentially compromised right ventricular volume due to the left ventricle-to-aorta baffle. Because the Rastelli operation risks later development of left ventricular outflow tract obstruction, aortic translocation can be considered for these patients. We report a case of double-outlet right ventricle with left ventricular outflow tract obstruction in the setting of dextrocardia, left juxtaposition of the atrial appendages, and a small tricuspid valve, which was successfully managed with a biventricular repair by means of an aortic translocation technique.
Bautista-Hernandez
Victor
V
Department of Cardiac Surgery, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
Nento
Daniel E
DE
Colan
Steven D
SD
Geva
Tal
T
Pigula
Frank A
FA
D001011:Aorta / Q000637:transplantation; D001013:Aorta, Thoracic / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D020517:Atrial Appendage / Q000002:abnormalities; D003914:Dextrocardia / Q000175:diagnosis / Q000601:surgery*; D004310:Double Outlet Right Ventricle / Q000175:diagnosis / Q000601:surgery*; D004452:Echocardiography; D006333:Heart Failure / Q000517:prevention & control*; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011664:Pulmonary Valve / Q000002:abnormalities / Q000601:surgery; D011666:Pulmonary Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D014184:Transplantation, Homologous; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000601:surgery*; D014261:Tricuspid Valve / Q000002:abnormalities / Q000601:surgery; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000601:surgery