Steven F. Thrupp, MA (Hons), MBChB, Thomas L. Gentles, FRACP, Alan R

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Presentation transcript:

Arterial Switch Operation: Early and Late Outcome for Intramural Coronary Arteries Steven F. Thrupp, MA (Hons), MBChB, Thomas L. Gentles, FRACP, Alan R. Kerr, FRACS, Kirsten Finucane, FRACS The Annals of Thoracic Surgery Volume 94, Issue 6, Pages 2084-2090 (December 2012) DOI: 10.1016/j.athoracsur.2012.07.013 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Coronary unroofing with transfer to medially based trapdoor flaps. (A) The aorta is divided well above the sinotubular junction. (B) Fine scissors are used to unroof the intramural segment of the coronary artery. (C) Each flap is elevated and excised cleanly using fine scissors or a blade. (D) The two coronaries are then excised with button tissue around each orifice and transferred, as usual, to medially based trapdoor flaps swung out from the front of the main pulmonary artery. The Annals of Thoracic Surgery 2012 94, 2084-2090DOI: (10.1016/j.athoracsur.2012.07.013) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Pericardial hood technique. (A) The upper edge is sutured to a scooped out edge, cut into the front of the neoaorta at the correct level. (B) An oval patch of pericardium is fashioned to cover the large button, creating a complete anterior pouch. The Annals of Thoracic Surgery 2012 94, 2084-2090DOI: (10.1016/j.athoracsur.2012.07.013) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Kaplan-Meier survival probability curves for intramural coronary artery pattern (IMCA) and non-IMCA cohorts. The Annals of Thoracic Surgery 2012 94, 2084-2090DOI: (10.1016/j.athoracsur.2012.07.013) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions