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Anatomic repair for congenitally corrected transposition of the great arteries  Rajesh Sharma, Sachin Talwar, Ashutosh Marwah, Sejal Shah, Sunita Maheshwari,

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Presentation on theme: "Anatomic repair for congenitally corrected transposition of the great arteries  Rajesh Sharma, Sachin Talwar, Ashutosh Marwah, Sejal Shah, Sunita Maheshwari,"— Presentation transcript:

1 Anatomic repair for congenitally corrected transposition of the great arteries 
Rajesh Sharma, Sachin Talwar, Ashutosh Marwah, Sejal Shah, Sunita Maheshwari, Pujari Suresh, Rajnish Garg, Bijender Singh Bali, Rajnish Juneja, Anita Saxena, Shyam Sunder Kothari  The Journal of Thoracic and Cardiovascular Surgery  Volume 137, Issue 2, Pages e4 (February 2009) DOI: /j.jtcvs Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Actuarial survival in patients undergoing the double switch operation. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Reoperation-free survival in patients undergoing the double switch operation. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Event-free survival in patients undergoing the double switch operation. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

5 Technique of Senning operation using in situ pericardium
Technique of Senning operation using in situ pericardium. Points b and a on the free edge of the intact pericardial reflection (P) are approximated to points b' and a' on the anterior lip of the right atriotomy incision. Opening in right pulmonary veins (arrow). SVC, Superior vena cava; IVC, inferior vena cava. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

6 Through a right ventriculotomy, two patches are sutured, one around the VSD edge and the other around the aortic annulus, both sutured together midway. It is important to form the inferior edge of the tunnel by suturing to the anterior tricuspid valve annulus (arrow), and not valve leaflet, to prevent disruption. AO, Aorta; TV, tricuspid valve; PA, pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

7 Coronary artery anatomy in CCTGA with relative positions of aortic and pulmonary roots. (A) Schematic drawing of coronary artery origin; (B) distribution of coronary arteries. Note the discrepancy between the size of the aorta (AO) and the pulmonary artery (PA). For details see text. LCA, Left coronary artery, RCA, right coronary artery; AD, anterior descending, CX, circumflex. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

8 (A) Method of coronary transfer, construction of “keel” (arrow), and (B) final reconstruction after the ASO. Note the site of implantation of left and right coronary buttons to prevent kinking or stretching of coronary arteries and the shifting of the pulmonary artery anastomosis to the left to avoid coronary compression. For details see text. AO, Aorta; LCA, left coronary artery, RCA, right coronary artery; P, pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery  , e4DOI: ( /j.jtcvs ) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

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