title: Management of the ventricular septal defect during double switch operation for atrioventricular discordant connections.
abstract: Management of the ventricular septal defect at the time of the double switch operation can be challenging and deserves careful attention to the anatomic details of ventricular septal defect location, alignment with the appropriate subtended ventricles and their respective atrioventricular valves, and the disposition of the specialized conduction tissue. These anatomic details can differ considerably from hearts with concordant atrioventricular alignments, and further variations of right-left geometry and septal alignment can be exhibited. A case is described that underscores some of the particular challenges associated with management of the ventricular septal defect during double switch operation for hearts with discordant atrioventricular connections and either transposition of the great arteries or double outlet right ventricle.
authors: Department of Pediatric and Adult Congenital Heart Surgery, Center for Pediatric and Adult Congenital Heart Diseases, Cleveland Clinic, The Children's Hospital, Cleveland, OH, USA. mavrouc@ccf.org
authors: Constantine
authors: C
authors: Mavroudis
authors: Robert D
authors: RD
authors: Stewart
authors: Lourdes R
authors: LR
authors: Prieto
authors: Kenneth
authors: K
authors: Zahka
authors: Marshall L
authors: ML
authors: Jacobs
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000601:surgery*; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D004310:Double Outlet Right Ventricle / Q000000981:diagnostic imaging / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome