Coronary Reimplantation After Neoaortic Reconstruction Can Yield Better Result in Arterial Switch Operation: Comparison With Open Trap Door Technique

Chang, Yun Hee; Sung, Si Chan; Lee, Hyoung Doo; Kim, Si-Ho; Woo, Jong Soo; Lee, Young Seok

doi:10.1016/j.athoracsur.2005.04.056

Cited by 18 publications

(22 citation statements)

References 12 publications

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“…17 Chang et al reported a comparison of the results between the technique of coronary reimplantation after neoaortic reconstruction and the open trapdoor technique. 40 They emphasized that coronary reimplantation after neoaortic reconstruction minimizes coronary artery Anterior pulmonary wall was incised in a medially hinged J shape (1). The coronary cuff was sewn, starting at the bottom of the J-shaped incision and the inferior end of the cuff (2).…”

Section: Looping Course (Planché Group III /Yacoub Type D or E)mentioning

confidence: 99%

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

Suzuki

2009

Gen Thorac Cardiovasc Surg

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The arterial switch operation has evolved into the treatment of choice for most forms of transposition of the great arteries (TGA). Recently reported operative mortality of the procedure has fallen to the range of 1.1%-6.0%, even for complex forms of TGA. Despite advancement in the technical aspects of the procedure, certain anatomical variations of the coronary arteries, such as a single coronary orifice and/or intramural coronary artery, are still considered surgical risks in many centers. Optimizing the surgical technique for relocating these challenging variations of the coronary anatomy is key to improving the surgical outcomes for the procedure. In this review, the surgical modifications of the arterial switch operation for TGA associated with complex patterns of the coronary arteries are examined.

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Section: Looping Course (Planché Group III /Yacoub Type D or E)mentioning

confidence: 99%

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

Suzuki

2009

Gen Thorac Cardiovasc Surg

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“…Our coronary re-implantation technique ensured the very accurate selection of the coronary transfer site. Moreover, we believe that this approach is more effective in situations with significant size mismatches of the great arteries or unusual coronary artery patterns [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…The divided small distal ascending aorta and aortic arch were reconstructed with glutaraldehyde-treated autologous pericardial patches that were adjusted for the size of the large proximal main pulmonary artery. The coronary artery transfer technique utilized in our center has previously been described [ 2 ]. The coronary arteries were transferred to the neoaorta after completion of the neoaorta and aortic arch reconstructions.…”

Section: Methodsmentioning

confidence: 99%

Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years

et al. 2015

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The surgical management of transposition complex with aortic arch obstruction remains technically demanding due to anatomic complexity. Even in the recent surgical era, there are centers that address this anomaly with a staged strategy. This report presents our experiences with a one-stage repair of transposition complexes with aortic arch obstructions more than the last 10 years. Since 2003, 19 patients with a transposition of the great arteries (TGA, 2 patients) or a double outlet of the right ventricle (DORV, 17 patients) and aortic arch obstruction have undergone one-stage repair of their anomalies. The mean age was 6.7 ± 2.3 days, and the mean body weight was 3.4 ± 0.3 kg. The 2 patients with TGA exhibited coarctation of the aorta. The 17 patients with DORV all exhibited the Taussig–Bing type. The great artery relationships were anteroposterior in 4 patients (21.1 %). The coronary artery anatomies were usual (1LCx; 2R) in 8 patients (42.1 %). There were 2 early deaths (10.5 %). Seven patients (36.8 %) required percutaneous interventions. One patient required re-operation for pulmonary valvar stenosis and left pulmonary artery patch angioplasty. The overall survival was 84.2 %. The freedom from mortality was 83.5 % at 5 years, and the freedom from intervention was 54.4 % at 5 years. The one-stage repair of transposition complexes with aortic arch obstructions resulted in an acceptable survival rate and a relatively high incidence of postoperative catheter interventions. Postoperative catheter interventions are highly effective. Transposition complexes combined with aortic arch obstructions can be managed by one-stage repair with good early and midterm results.

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“…No important changes in preoperative, intraoperative, and postoperative managements were established during this study period, including myocardial protection and cardiopulmonary bypass (CPB) strategy. The operative technique was described in detail in our previous report [4], but the coronary transfer technique is summarized here. In the OCR technique, after creation of the coronary buttons, the main pulmonary artery (MPA) was cut at the site about 2 mm proximal to its bifurcation.…”

Section: Methodsmentioning

confidence: 99%

“…The main advantage of this technique is that surgeons can easily identify the accurate site of the CA transfer regardless of CA anatomy, alignment of the facing commissure, and level of CA origin, which can reduce CA transfer related problems. We reported better results of coronary reimplantation after neoaortic reconstruction (CRANR) in 2005 [4]. However, many pediatric cardiac surgeons are currently using the open coronary reimplanation (OCR) technique.…”

Section: Introductionmentioning

confidence: 99%

The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation

Choi

Sung

Kim

et al. 2019

J Cardiothorac Surg

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Background The aim of this study was to determine if there was a difference between coronary reimplantation after neoaortic reconstruction and open coronary reimplantation technique in arterial switch operation (ASO). Methods A total of 236 patients who underwent ASO from March 1994 to August 2018 were enrolled in this study. Multivariate analysis was performed for postoperative early mortality. Patients were divided into the open coronary reimplantation and coronary reimplantation after neoaortic reconstruction groups. The 30-day mortality, intraoperative and postoperative coronary artery (CA) revisions, CA–related late morbidity and mortality, and early and late neoaortic valve regurgitations after ASO were compared between the two groups. Results Overall postoperative early mortality was 7.2% (17/236). Patients who underwent open coronary reimplantation had higher early mortality as compared with those who underwent coronary reimplantation after neoaortic reconstruction. Risk factors for postoperative early mortality from multivariate analysis were cardiopulmonary bypass time and open coronary reimplantation. There was a higher incidence of CA–related late mortality or morbidity in the open coronary reimplantation group. The open coronary reimplantation group had a higher incidence of intraoperative or postoperative CA revision. There were no differences in the incidence of mild or more neoaortic valve regurgitation at discharge or in the 5-year freedom from mild or more neoaortic valve regurgitation. Conclusions CA reimplantation after neoaortic reconstruction yields better results in mortality and intraoperative or postoperative CA–related problems in ASO without increasing postoperative neoaortic valve regurgitation.

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Coronary Reimplantation After Neoaortic Reconstruction Can Yield Better Result in Arterial Switch Operation: Comparison With Open Trap Door Technique

Cited by 18 publications

References 12 publications

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

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

Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years

The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation

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