Half-turned truncal switch operation for complete transposition of the great arteries with ventricular septal defect and pulmonary stenosis

The case of prenatal ultrasound diagnosis of complete transposition of the great arteries and dextrocardia in the fetus with left juxtaposition of the atrial appendages and subpulmonary ventricular septal defect in the third trimester is presented. The postnatal echocardiography confirmed the prenatal diagnosis. At 2 months of life, first surgical intervention under extracorporeal circulation was performed: the arterial switch operation and narrowing of the dilated pulmonary artery root, closure of patent foramen ovale, ligation of patent ductus arteriosus. At the age of 8 months, the child underwent a second operation: closure of ventricular septal defect with the transventricular approach and plastic surgery of the pulmonary artery. After an operation third-degree atrioventricular block (bradyarrhythmias) has occurred and 2 weeks later patient's health improvement was achieved, and he underwent implantation of a single-chamber pacemaker. Currently, the child is 2 years old, physical and mental development corresponds to age and he remains under the supervision of specialists.

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Complete transposition of the great arteries with ventricular septal defect and pulmonary stenosis in a Thoroughbred foal

Equine Veterinary Journal ◽

10.1111/j.2042-3306.1983.tb01830.x ◽

1983 ◽

Vol 15 (4) ◽

pp. 377-380 ◽

Cited By ~ 11

Author(s):

JILL J. McCLURE ◽

CATHY E. GABER ◽

J. W. WATTERS ◽

C. W. QUALLS

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Pulmonary Stenosis ◽

Complete Transposition

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Primary Intracardiac Repair of Double Outlet Right Ventricle and Ventricular Septal Defect without Pulmonary Stenosis

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239500300403 ◽

1995 ◽

Vol 3 (3-4) ◽

pp. 103-108

Author(s):

KG Jaya Prasanna ◽

Krishna Subramony Iyer ◽

Rajesh Sharma ◽

Balram Airan ◽

Ivatury Mrityonjaya Rao ◽

...

Keyword(s):

Left Ventricle ◽

Ventricular Septal Defect ◽

Right Ventricle ◽

Septal Defect ◽

Arterial Switch Operation ◽

Pulmonary Stenosis ◽

Double Outlet Right Ventricle ◽

Arterial Switch ◽

Intracardiac Repair ◽

Switch Operation

From January 1991' to May 1994, 29 patients with double outlet right ventricle with ventricular septal defect, without pulmonary stenosis underwent primary intracardiac repair at the All India Institute of Medical Sciences, New Delhi. Patients were classified into 4 groups based on location of the ventricular septal defect. The ventricular septal defect was subaortic in 11, subpulmonary in 13, doubly committed subarterial in 1, and noncommitted in 4 patients. Surgical treatment consisted of intraventricular routing of the left ventricle to the aorta (17), and the left ventricle to the pulmonary artery followed by an arterial switch operation (12). There were 4 (13.9%) early deaths. Follow-up ranged from 3 months to 3 years (mean, 1.5 years). There was no late mortality. Three patients had residual ventricular septal defect, one of whom has undergone reoperation. One patient has a gradient of 25 mmHg across the left ventricular outflow tract. Double outlet right ventricle with subpulmonic ventricular septal defect was found to be a significant risk factor for early mortality (p = 0.03). The subgroup of double outlet right ventricle with subpulmonic ventricular septal defect who had a combination of single coronary artery and post arterial switch operation was particularly prone to pulmonary hypertensive crisis and hospital death (p = 0.002).

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Surgical Considerations of Ventricular Septal Defect Associated with Complete Transposition of the Great Arteries and Pulmonary Stenosis

Circulation ◽

10.1161/01.cir.44.5.914 ◽

1971 ◽

Vol 44 (5) ◽

pp. 914-923 ◽

Cited By ~ 23

Author(s):

E. S. IMAMURA ◽

TETSUO MORIKAWA ◽

KATSUHIKO TATSUNO ◽

SOUJI KONNO ◽

TATSUTA ARAI ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Pulmonary Stenosis ◽

Complete Transposition

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Anatomic correction of complete transposition with ventricular septal defect in neonates: experience with 42 consecutive cases

Cardiology in the Young ◽

10.1017/s1047951100000172 ◽

1991 ◽

Vol 1 (1) ◽

pp. 101-103 ◽

Cited By ~ 8

Author(s):

Claude Planché ◽

Alain Serraf ◽

François Lacour-Gayet ◽

Jacqueline Bruniaux ◽

François Bouchart

Keyword(s):

Left Ventricle ◽

Ventricular Septal Defect ◽

Septal Defect ◽

Arterial Switch Operation ◽

Systemic Circulation ◽

Ventricular Septum ◽

Intact Ventricular Septum ◽

Complete Transposition ◽

The Poor ◽

Switch Operation

Perhaps paradoxically, it was in the form of complete transposition with a ventricular septal defect rather than an intact ventricular septum that the arterial switch operation was first successfully applied. This was, in part, because of the poor results of the physiologic repair in the presence of a ventricular septal defect, but more because the left ventricle, in the presence of the septal deficiency, is immediately suitable for supporting postoperatively the increased workload imposed on the systemic circulation. Spurred by this success, the procedure was then extended to neonates born with complete transposition and an intact ventricular septum and is currently employed with good results in this group.

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Is the function of all cardiac valves after the arterial switch operation influenced by an associated ventricular septal defect?

Cardiology in the Young ◽

10.1017/s1047951111000084 ◽

2011 ◽

Vol 21 (4) ◽

pp. 383-391

Author(s):

J. Gabriel ◽

H.-H. Scheld ◽

T.D.T. Tjan ◽

N. Osada ◽

Thomas Krasemann

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Arterial Switch Operation ◽

Pulmonary Stenosis ◽

Ventricular Septum ◽

Intact Ventricular Septum ◽

Cardiac Valves ◽

Arterial Switch ◽

Switch Operation

AbstractA ventricular septal defect in transposition of the great arteries is frequently closely related to the cardiac valves. The valvar function after arterial switch operation of patients with transposition of the great arteries and ventricular septal defect or intact ventricular septum was compared. We analysed the function of all cardiac valves in patients who underwent the arterial switch operations pre- and post-operatively, 1 year after the procedure and on follow-up. The study included 92 patients – 64 with transposition of the great arteries/intact ventricular septum and 28 with transposition of the great arteries/ventricular septal defect. The median age at surgery was 5.5 days in transposition of the great arteries/intact ventricular septum (0–73 days) and 7.0 days in transposition of the great arteries/ventricular septal defect (4–41 days). Follow-up was 51.7 months in transposition of the great arteries/intact ventricular septum (3.3–177.3 months) and 55 months in transposition of the great arteries/ventricular septal defect (14.6–164.7 months). Neo-aortic, neo-pulmonary, and mitral valvar function did not differ. Tricuspid regurgitation was more frequent 1 year post-operatively in transposition of the great arteries/ventricular septal defect (n = 4) than in transposition of the great arteries/intact ventricular septum. The prevalence of neo-aortic regurgitation and pulmonary stenosis increased over time, especially in patients with transposition of the great arteries/intact ventricular septum. The presence of a ventricular septal defect in patients undergoing arterial switch operation for transposition of the great arteries only has a minor bearing for the development of valvar dysfunction on the longer follow-up.

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Double Root Translocation Operation for Complete Transposition of Great Arteries with Ventricular Septal Defect and Pulmonary Stenosis & Double-Outlet Right Ventricle with Non-committed Ventricular Septal Defect and Pulmonary Stenosis

Surgery of Conotruncal Anomalies ◽

10.1007/978-3-319-23057-3_21 ◽

2016 ◽

pp. 357-374 ◽

Cited By ~ 1

Author(s):

Shengshou Hu

Keyword(s):

Ventricular Septal Defect ◽

Right Ventricle ◽

Septal Defect ◽

Pulmonary Stenosis ◽

Double Outlet Right Ventricle ◽

Double Root ◽

Transposition Of Great Arteries ◽

Complete Transposition

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The spectrum of pulmonary input impedance in children with complete transposition after the arterial switch operation

Cardiology in the Young ◽

10.1017/s1047951100006053 ◽

1998 ◽

Vol 8 (2) ◽

pp. 180-186

Author(s):

Tomoaki Murakami ◽

Toshio Nakanishi ◽

Makoto Nakazawa ◽

Kazuo Momma ◽

Yasuharu Imai

Keyword(s):

Ventricular Septal Defect ◽

Input Impedance ◽

Septal Defect ◽

Arterial Switch Operation ◽

Characteristic Impedance ◽

Pulmonary Trunk ◽

Pulmonary Vasculature ◽

Arterial Switch ◽

Complete Transposition ◽

Switch Operation

AbstractWe evaluated the physical characteristics of the pulmonary trunk in 32 patients with complete transposition after the arterial switch operation, calculating the pulmonary input impedance. In 6 of the patients, the characteristic impedance was equal to, or less than, the value in patients with ventricular septal defect. In those patients with an intact ventricular septum, or those with a ventricular septal defect who had undergone the arterial switch operation or banding of the pulmonary trunk before 3 months age, the frequency of the first modulus minimum also agreed with the values obtained in patients with ventricular septal defect. The value was high, however, in patients with complete transposition with ventricular septal defect who had undergone an arterial switch operation or banding of the pulmonary trunk after 4 months of age. Our data suggest decreased distensibility of the proximal pulmonary trunk after the arterial switch operation, and mild changes in the pulmonary vasculature in patients with complete transposition with ventricular septal defect who had undergone either an arterial switch operation or banding of the pulmonary trunk after 4 months of age. Long-term follow-up is needed clarify whether or not these features affect right ventricular function by means of an increase in afterload.

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Réparation à l'Etage Ventriculaire — The REV procedure: Technique and clinical results

Cardiology in the Young ◽

10.1017/s104795110000010x ◽

1991 ◽

Vol 1 (1) ◽

pp. 63-70 ◽

Cited By ~ 26

Author(s):

Yves Lecompte

Keyword(s):

Ventricular Septal Defect ◽

Septal Defect ◽

Operative Mortality ◽

Pulmonary Stenosis ◽

Clinical Results ◽

Classical Approach ◽

Late Death ◽

Residual Defect ◽

Technical Errors ◽

Complete Transposition

SummaryFrom November 1982 to July 1989, fifty patients were treated by the REV procedure for complete transposition associated with ventricular septal defect and obstruction of the pulmonary outflow tract. The age at operation ranged from 4 months to 15 years (mean 3.8 years). The technique, based on the resection of the outlet (infundibular) septum, is described in detail. Operative mortality was 18%, essentially related to technical errors or faulty indications at the beginning of our experience. There was no late death. Six patients needed reoperation for pulmonary stenosis (2 cases) or a residual defect, in some cases associated with tricuspid regurgitation. All survivors were in excellent clinical condition. The REV procedure has fewer limitations and better results than the classical approach using Rastelli's procedure.

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