“Bay window” technique for the arterial switch operation of the transposition of the great arteries with complex coronary arteries

Impact of Coronary Artery Anatomy in Arterial Switch Procedure on Early Mortality and Morbidity

“…24 Yamagishi and colleagues reported the "bay window technique." 25 Coronary ostium upside-down method was first described by Yacoub and Radley-Smith. 26 Asou et al described a method for intramural coronary arteries by creating two separate buttons.…”

Modification of the arterial switch operation for transposition of the great arteries with complex coronary artery patterns

“…They speculated that compression of both ostia by the pulmonary trunk contributes to rapid progression of the coronary obstruction. 33 The latest modifi cation is the "bay window technique" reported by Yamagishi and colleagues 34 (Fig. 5).…”

“…In the case of bilateral bay window channels, the superior ends of the bilateral cuff are directly anastomosed together (5). (From Yamagishi et al 34 with permission from Elsevier) transfer-related mortality or morbidity, and it is the procedure of choice, particularly for variations of a single sinus coronary artery. 41 Recently, a University of Michigan group reported the midterm results of coronary reimplantation after neoaortic reconstruction in 168 patients.…”

Is Preoperative Delineation of Coronary Artery Pattern a Prerequisite for Arterial Switch Operation?

“…The most important part of the arterial switch procedure may be the successful translocation of the coronary arteries without producing kinking or torsion. Various transfer techniques have been proposed to achieve a truly anatomic position of the coronary arteries while avoiding coronary insufficiency, such as: (1) medially hinged trapdoor flap technique, 4 (2) circular buttonhole reimplantation, (3) bay window technique, 19 (4) in-situ coronary reallocation, 11,20 and (5) pericardial hood augmentation of the trapdoor transfer. 10 From the clinical experience presented in this review, except for single ostium intramural pattern, the trapdoor and buttonhole techniques are the most practical and applicable maneuvers of coronary transfer during ASO.…”