George M. Alfieris, MD, James J. Gangemi, MD, Mathew P

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Modified Repair of Truncus Arteriosus to Maintain Pulmonary Artery Architecture George M. Alfieris, MD, James J. Gangemi, MD, Mathew P. Schiralli, MD, Michael F. Swartz, PhD, Jill M. Cholette, MD The Annals of Thoracic Surgery Volume 90, Issue 3, Pages 1038-1039 (September 2010) DOI: 10.1016/j.athoracsur.2009.11.045 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 A transverse incision is made onto the common trunk extending out onto the left pulmonary artery allowing visualization of the aorta pulmonary window, the branch pulmonary arteries, and the truncal valve. The truncal root is septated using a 0.4-mm polytetrafluoroethylene patch and running 6-0 Prolene suture (Ethicon, Somerville, NJ). The Annals of Thoracic Surgery 2010 90, 1038-1039DOI: (10.1016/j.athoracsur.2009.11.045) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The ventricular septal defect is closed through a right ventriculotomy. The Annals of Thoracic Surgery 2010 90, 1038-1039DOI: (10.1016/j.athoracsur.2009.11.045) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 An appropriate sized aortic homograft establishes continuity between the right ventricle and the pulmonary arteriotomy. The angled nature of the arch of the distal aortic homograft allows the conduit to sit in a position similar to the native pulmonary artery. The Annals of Thoracic Surgery 2010 90, 1038-1039DOI: (10.1016/j.athoracsur.2009.11.045) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions