The hemi-Mustard/bidirectional Glenn atrial switch procedure in the double-switch operation for congenitally corrected transposition of the great arteries:

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The hemi-Mustard/bidirectional Glenn atrial switch procedure in the double-switch operation for congenitally corrected transposition of the great arteries: Rationale and midterm results Sunil P. Malhotra, MD, V. Mohan Reddy, MD, Mary Qiu, BS, Timothy J. Pirolli, MD, Laura Barboza, BS, Olaf Reinhartz, MD, Frank L. Hanley, MD The Journal of Thoracic and Cardiovascular Surgery Volume 141, Issue 1, Pages 162-170 (January 2011) DOI: 10.1016/j.jtcvs.2010.08.063 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 The surgical approach to anatomic repair in 48 patients. ccTGA, Congenitally corrected transposition of the great arteries; PAB, pulmonary artery banding; AAS, arterial–atrial switch; RAS, Rastelli–atrial switch. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 162-170DOI: (10.1016/j.jtcvs.2010.08.063) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Age distribution of patients at the time of anatomic repair. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 162-170DOI: (10.1016/j.jtcvs.2010.08.063) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Illustration of the hemi-Mustard/bidirectional Glenn (BDG) operation with the arterial–atrial switch procedure in a dextrorotated heart. IVC, Inferior vena cava; LV, left ventricle; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 162-170DOI: (10.1016/j.jtcvs.2010.08.063) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Illustration of hemi-Mustard/bidirectional Glenn (BDG) operation with the Rastelli–atrial switch procedure in a dextrorotated heart. IVC, Inferior vena cava; LV, left ventricle; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 162-170DOI: (10.1016/j.jtcvs.2010.08.063) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Freedom from reoperation in the Rastelli–atrial switch (RAS) and arterial–atrial switch (AAS) procedures was not statistically different (P = .09). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 162-170DOI: (10.1016/j.jtcvs.2010.08.063) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Freedom from reoperation on the right ventricular outflow tract (RVOT) was significantly greater in the hemi-Mustard group compared with that seen in the conventional atrial baffle group (P = .019). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 162-170DOI: (10.1016/j.jtcvs.2010.08.063) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Tricuspid regurgitation (TR) grade decreased from 2.2 ± 1.0 to 1.3 ± 0.5 after the double-switch (DS) procedure (P = .00004). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 162-170DOI: (10.1016/j.jtcvs.2010.08.063) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 8 Functional status after anatomic repair. All patients undergoing the Rastelli–atrial switch (RAS) procedure were in New York Heart Association class I at follow-up. Impaired functional status was found in 4 patients undergoing the arterial–atrial switch (AAS) procedure. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 162-170DOI: (10.1016/j.jtcvs.2010.08.063) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions