The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 282-289, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
A new approach to total repair of transposition of the great vessels: a technique for atrial autotransplantation
K Taguchi, H Matsumura, M Hirao, K Kato and M Itano
We have devised a new operative procedure called atrial autotransplantation
for transposition of the great vessels and applied it in 7 cases. Results
were satisfactory except for one death. The bais of this technique was the
experiment, using 70 dogs, in which the relationship of separation of the
atrial wall and atrial septum to the development of arrhythmia was studied.
It was found that reservation of the upper one sixth of the right atrial
wall and the upper one third of the left atrial wall developed almost no
significant arrhythmia with slow rate. By this concept and method, the left
and right atria are almost completely separated, and a complete
intraventricular and intra- atrial repair is made in a satisfactory
operative field. Since there is no surgical intervention in the ventricular
wall, postoperative cardiac function can be satisfactorily maintained. With
this procedure intr- atrial conversion was performed in four cases and
intraventricular conversion in three cases-the former for type I of
uncomplicated transposition and type III of combined pulmonary stenosis,
with or without VSD, and the latter for type II of combined large VSD. Only
one patient with intraventricular conversion died of low cardiac output
syndrome, probably due to incomplete relief of combined pulmonary stenosis.
