Nikaidoh Procedure for the Correction of Transposition of the Great Arteries, Ventricular Septal Defect, and Pulmonary Stenosis

History of cardiac and thoracic surgery A cardiac surgeon, his way to holiness, and his heritage – the 80 th anniversary of Giancarlo Rastelli’s birthday and the 45 th anniversary of the first Rastelli procedure

“…This method, which includes elements of the Ross, Jatene, and Konno procedures, consists in separating the aorta from the right ventricle, removing left ventricular outflow tract obstructions by intersecting the conal septum and excising the pulmonary valve, reconstructing the left ventricular outflow tract leading to the translocated aorta with a patch appropriately sutured onto the ventricular septal defect, and reconstructing the right ventricular outflow tract using a pericardial patch. Modifications of this method include translocation of coronary vessels during aortic translocation (to prevent ischemia), the Lecompte maneuver, and reconstruction of the right ventricular outflow tract with a pulmonary homograft or the establishment of a direct connection of the right ventricle with the pulmonary artery [17,18].…”

“…In such situations, it may sometimes be the only option for biventricular correction [17][18][19]. It is believed that abnormal distribution of the coronary arteries constitutes a contraindication for the Nikaidoh procedure, but, in 2011, the journal Cardiology in the Young published a description of a successful operation with this technique performed in a patient whose anterior interventricular branch of the left coronary artery crossed the right ventricular outflow tract [20].…”

Modified Nikaidoh procedure in a patient with transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction with unusual coronary anatomy

“…arteries with ventricular septal defect and left ventricular outflow tract obstruction represents a minor group among congenital cardiac defects; [1][2][3][4][5][6][7][8] however, the combination is a challenge among paediatric cardiac surgeons. Different surgical techniques such as the Rastelli procedure, Réparation à l'Etage ventriculaire and the Metras modification, and Nikaidoh operation and its modifications were defined; however, the Rastelli procedure has been the most common surgical treatment up to date.…”

“…Different surgical techniques such as the Rastelli procedure, Réparation à l'Etage ventriculaire and the Metras modification, and Nikaidoh operation and its modifications were defined; however, the Rastelli procedure has been the most common surgical treatment up to date. [1][2][3][4][5][6][7][8] However, long-term results of the Rastelli procedure, Réparation à l'Etage ventriculaire, and the Metras modification carry risks of considerable mortality and morbidity, [1][2][3][4][5][6][7][8] and Nikaidoh operations and its modifications still require long-term follow-up results in larger series.…”

“…Despite the limited number of patients and followup data, the originally described Nikaidoh procedure in 1984, 1 and its various modifications presented in recent years, [2][3][4][5] seem promising. The literature consists of reports indicating unusual coronary anatomy as a contraindication for the Nikaidoh operation.…”