Root translocation in congenitally corrected transposition of the great arteries with ventricular septal defect and pulmonary stenosis, and other lesions.
The pulmonary root translocation (PRT) procedure has been used to correct ventriculoarterial discordance or malposition of great arteries since 1994. It was part of the surgical repair of 62 consecutive patients presenting with congenitally corrected transposition of the great arteries (CCTGA) with ventricular septal defect (VSD) and pulmonary stenosis (PS), or other complex congenital heart disease with malposition of the great arteries, VSD, and PS. PRT was performed as follows: removal of the pulmonary artery (PA) with the pulmonary valve from its abnormal position, closure of the consequent hole with an autologous pericardial patch, resection of some conal septum, creation of an intraventricular tunnel connecting the left ventricle to the aorta, and construction of a new right ventricular outflow tract using the translocated PA. In patients presenting with important pulmonary valve stenosis, the pulmonary artery was enlarged with a monocusp valve pericardial patch. The Senning procedure was used with some modification to complete the anatomical repair in CCTGA patients. Overall in-hospital and long-term mortality were 4.8% and 3.4%, respectively. PRT appears to be a good surgical alternative for patients presenting with CCTGA with VSD and PS, and other lesions involving malposition of the great arteries, VSD, and PS.
Department of Cardiovascular Surgery, Hospital Beneficencia Portuguesa of São Paulo, Brazil; Paulista School of Medicine, Federal University of Sao Paulo, Brazil. Electronic address: dasilvajp@uol.com.br.
Jose Pedro
JP
Da Silva
Department of Cardiovascular Surgery, Hospital Beneficencia Portuguesa of São Paulo, Brazil; Paulista School of Medicine, Federal University of Sao Paulo, Brazil.
Luciana Fonseca
LF
Da Silva
Department of Cardiovascular Surgery, Hospital Beneficencia Portuguesa of São Paulo, Brazil.
Jose Francisco
JF
Baumgratz
Department of Cardiovascular Surgery, Hospital Beneficencia Portuguesa of São Paulo, Brazil.
Rodrigo Moreira
RM
Castro
Department of Cardiovascular Surgery, Hospital Beneficencia Portuguesa of São Paulo, Brazil.
Rodrigo Freire
RF
Bezerra
Department of Cardiovascular Surgery, Hospital Beneficencia Portuguesa of São Paulo, Brazil; Paulista School of Medicine, Federal University of Sao Paulo, Brazil.
Jose Cicero
JC
Guilhen
D000069278:Arterial Switch Operation / Q000379:methods*; D000080041:Congenitally Corrected Transposition of the Great Arteries; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D011666:Pulmonary Valve Stenosis / Q000150:complications / Q000601:surgery*; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery*
Transposition of the great arteries; cardiac surgery; congenital heart disease; pulmonary stenosis; ventricular outflow tract obstruction; ventricular septal defect