1. Arterial switch after failed atrial baffle procedures for transposition of the great arteries 
Constantine Mavroudis, MD, Carl L Backer, MD 
The Annals of Thoracic Surgery 
Volume 69, Issue 3, Pages (March 2000)
DOI: /S (99)

2. Fig 1
Representation of instrumentation and interventricular septal geometry before (A) and after (B) preparatory pulmonary artery band (PAB) in a patient with transposition of the great arteries after a failed atrial baffle procedure. The proximal pulmonary artery pressure is measured simultaneously with the systemic pressure. As the band is tightened, a rise in left ventricular (LV) pressure is noted, which is accompanied by an interventricular septal shift toward the right ventricle (RV; monitored by transesophageal echocardiography). This oftentimes results in improved tricuspid valve function and less tricuspid regurgitation (TR). Bold arrow represents severe TR, small arrow after PAB represents mild TR.
The Annals of Thoracic Surgery  , DOI: ( /S (99) )

3. Fig 2
Right atrial view in a patient with an established Mustard baffle operation for transposition of the great arteries undergoing baffle excision en route to arterial switch operation conversion. Care is taken to remove the entire atrial baffle (outlined by dashed line) without injuring the superior vena cava, the inferior vena cava, and the sinoatrial node. A coronary sinus catheter is placed for retrograde cardioplegia delivery.
The Annals of Thoracic Surgery  , DOI: ( /S (99) )

4. Fig 3
Right atrial view in a patient with an established Senning baffle operation for transposition of the great arteries undergoing baffle takedown. Care is taken to preserve the sinoatrial node and the original baffle connections for eventual reconnection to the posterior right atrial wall.
The Annals of Thoracic Surgery  , DOI: ( /S (99) )

5. Fig 4
Right atrial view in a patient who had Senning baffle takedown and is now undergoing baffle reconnection to the right posterolateral atrial wall en route to Gore-Tex (W.L. Gore & Assoc, Flagstaff, AZ) atrial septum reconstruction and arterial switch operation conversion.
The Annals of Thoracic Surgery  , DOI: ( /S (99) )

6. Fig 5
Right atrial view in a patient who had Mustard baffle excision and is now undergoing a right-sided Maze cryoablation procedure and Gore-Tex (W.L. Gore & Assoc, Flagstaff, AZ) reconstruction of the atrial septum. Lines of block are created to connect the inferoposterior os of the coronary sinus with the inferior vena cava, the edge of the atrial septal defect with the posterior atrial wall across the crista terminalis, and the atrial septal defect with the edge of the right atrial appendage. The Gore-Tex patch is placed to divide the anatomic left and right atria.
The Annals of Thoracic Surgery  , DOI: ( /S (99) )

7. Fig 6
Hemashield (Meadox Medicals Inc, Oakland, NJ) neoaortic valve-sparing reconstruction used to prevent proximal neoaortic dilatation and resultant neoaortic insufficiency. The pulmonary artery wall is removed and the contoured Hemashield graft is sewn into the resected sinuses of Valsalva. Appropriately sized holes are made in the corresponding facing sinuses for coronary reimplantation. The distal Hemashield graft is sutured end to end into the ascending aorta, thereby reconstructing the neoaorta.
The Annals of Thoracic Surgery  , DOI: ( /S (99) )

8. Fig 7
Aortic homograft implantation in a patient who had a Senning operation for transposition of the great arteries and moderate pulmonary stenosis. The patient underwent a preparatory PAB en route to arterial switch operation conversion by neoaortic reconstruction using an aortic homograft because of the poor quality of the existing pulmonary valve (neoaortic valve).
The Annals of Thoracic Surgery  , DOI: ( /S (99) )