Arterial switch operation for transposition of the great arteries with anomalies of cardiac situs and aortic position

Arterial switch operation in patients with transposition and a left-sided aorta

“…( b ) MIP reformatted image in the axial oblique plane. Ao=aorta; LAD=left anterior descending coronary artery; RCA=right coronary artery; RCC=right coronary cusp (Reproduced with permission from Talwar et al 17 Copyright American Association for Thoracic surgery).…”

“…( b ) MIP reformatted image in the axial oblique plane. Ao=aorta; LAD=left anterior descending coronary artery; RCA=right coronary artery; RCC=right coronary cusp (Reproduced with permission from Talwar et al 17 Copyright American Association for Thoracic surgery).

Figure 2 Surgical drawing showing the operative steps. ( a ) External cardiac anatomy, ( b ) the aorta is transected and the coronary buttons are harvested.

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“…We have already described our suggested technical modifications. 17 Thus, the pulmonary trunk is transected well above the sinotubular junction. If needed, flaps can be fashioned out of the wall of the new aorta to provide a long coronary arterial button, thus permitting effective elongation of the reconstructed coronary arteries.…”

“…We found that the arterial switch procedure, when performed in this group of patients, needs to be further modified to achieve successful outcomes. We have already described our suggested technical modifications 17 . Thus, the pulmonary trunk is transected well above the sinotubular junction.…”