|Title:||Modified Arterial Switch Operation by Sharing the Common Wall between the Great Arteries||Authors:||CHIU, ING-SH
|Keywords:||Arterial switch operation;Coronary artery kinking;Suprapulmonary stenosis;Postoperative bleeding;Common wall In-situ transfer||Issue Date:||2001||Journal Volume:||v.100||Journal Issue:||n.2||Start page/Pages:||77-82||Source:||JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION||Abstract:||
Background: Suprapulmonary stenosis and coronary arterial obstruction remains problematic after an rterial switch operation (ASO). We used common wall and in-situ transfer to improve the current technique. Methods : From October 1996 to December 1997, 11 consecutive babies aged from 6 days to 3 months with transposition of the great arteries underwent modified ASO by sharing the common wall between the great arteries until above the anterior neoaortic suture-line for coronary and pulmonary artery reconstruction. Coronary arteries were of usual type in only 3 cases, five juxtacommissural origin, one had a high takeoff and all were redirected almost in-situ. Results : There was no early death; neither coronary nor bleeding problem was noted. One late death occurred after redo for suprapulmonary stenosis. This was caused by upward stretching of the left pulmonary artery, which was placed above the high left-sided neoaortic anastomosis for in-situ transfer of the high takeoff coronaries. Intraluminal gro wth of the adventitia also contributed to suprapulmonary stenosis, which decreased significantly when the common wall adventitia was cleaned in the last two cases. Ten patients were doing well at follow- up of 30.9±5.
|Appears in Collections:||醫學系|
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