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The Journal of Thoracic and Cardiovascular Surgery, Vol 100, 410-415, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
MN Ilbawi, SY DeLeon, CL Backer, CE Duffy, AJ Muster, VR Zales, MH Paul and FS Idriss
A modified approach to the surgical management of corrected transposition
of the great vessels with ventricular septal defect and pulmonary stenosis
or atresia was used successfully in two patients. The procedure consisted
of performing a venous switch operation, directing the blood flow from the
morphologically left ventricle (right- sided chamber) into the aorta
through the ventricular septal defect and inserting a valved conduit
between the left-sided morphologically right ventricle and the pulmonary
artery. This approach has several advantages when compared with the
traditional surgical management, which consists of closure of the
ventricular septal defect and a left ventricular (right-sided chamber) to
pulmonary artery conduit. It uses the morphologically left ventricle as the
systemic pumping chamber, thereby minimizing long-term ventricular failure.
It allows closure of the defect from the right ventricular side of the
septum, thus decreasing the prevalence of complete atrioventricular block.
It also avoids use of the tricuspid valve as the systemic atrioventricular
valve and therefore decreases the chance of postoperative valve
regurgitation.
ARTICLES
An alternative approach to the surgical management of physiologically corrected transposition with ventricular septal defect and pulmonary stenosis or atresia
Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, Chicago, IL 60614.
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