Root Translocation in Congenitally Corrected Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Stenosis, and Other Lesions

• Published in: Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual 2015, Vol.18 (1), p.34-39
• Main Authors: Da Silva, Jose Pedro, MD, Da Silva, Luciana Fonseca, MD, Baumgratz, Jose Francisco, MD, Castro, Rodrigo Moreira, MD, Bezerra, Rodrigo Freire, MD, Guilhen, Jose Cicero, MD
• Format: Article
• Language: English
• Subjects: Arterial Switch Operation - methods; cardiac surgery; Cardiothoracic Surgery; congenital heart disease; Heart Septal Defects, Ventricular - complications; Heart Septal Defects, Ventricular - surgery; Humans; Pediatrics; pulmonary stenosis; Pulmonary Valve Stenosis - complications; Pulmonary Valve Stenosis - surgery; Transposition of Great Vessels - complications; Transposition of Great Vessels - surgery; Transposition of the great arteries; ventricular outflow tract obstruction; ventricular septal defect
• ISSN: 1092-9126
• DOI: 10.1053/j.pcsu.2015.01.005

Abstract 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.