Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T00:38:13.599Z Has data issue: false hasContentIssue false

Extending the surgical boundaries in the management of the left ventricular outflow tract obstruction in discordant ventriculo-arterial connections – a surgical and morphological study

Published online by Cambridge University Press:  31 January 2008

Paula Martins
Affiliation:
Paediatric Cardiology Department, Paediatric Hospital of Coimbra, Portugal
Vi Tran
Affiliation:
Cardiac Unit, Institute of Child Health, London, United Kingdom
Gemma Price
Affiliation:
Cardiac Unit, Institute of Child Health, London, United Kingdom
Victor Tsang
Affiliation:
Cardiac Unit, Institute of Child Health, London, United Kingdom
Andrew C. Cook*
Affiliation:
Cardiac Unit, Institute of Child Health, London, United Kingdom
*
Correspondence to: Dr Andrew C Cook, Senior Lecturer, Cardiac Unit, Institute of Child Health, 30 Guilford St, London WC1N 1EH. Tel: +44 (0)207 905 2295; Fax: +44 (0)207 905 2324; E-mail: [email protected]

Abstract

When there is obstruction of the left ventricular outflow tract, there are several surgical approaches to the repair of discordant ventriculo-arterial connections in the setting of concordant atrioventricular connections. Choosing the optimal technique demands not only knowledge of the different surgical procedures, but also the understanding of the particular anatomic features present in a specific patient. These requisites are then essential to plan the operation, to foresee some difficult situations, and to avoid post-operative complications. In this review, we assess all these surgical and anatomic aspects, focussing on their relative importance in clinical assessment.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Stark, JF, de Leval, MR, Tsang, VT, Courtney, M. Surgery for Congenital Heart Defects. Wiley, 2006.Google Scholar
2. Van Son, JAM, Schaff, HV, Danielson, GK, Hagler, DJ, Puga, FJ. Surgical treatment of discrete and tunnel subaortic stenosis: late survival and risk of reoperation. Circulation 1993; 88: 159169.Google ScholarPubMed
3. Konno, S, Imai, Y, Iida, Y, Nakajima, M, Tatsuno, K. A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring. J Thorac Cardiovasc Surg 1975; 70: 909917.CrossRefGoogle ScholarPubMed
4. Rastan, H, Koncz, J. Aortoventriculoplasty: a new technique for the treatment of left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg 1976; 71: 920927.CrossRefGoogle ScholarPubMed
5. Calhoon, J, Bolton, J. Ross/Konno procedure for critical aortic stenosis in infancy. Ann Thorac Surg 1995; 60: S597S599.CrossRefGoogle ScholarPubMed
6. Shrivastava, S, Tadavarthy, SM, Fukuda, T, Edwards, JE. Anatomic causes of pulmonary stenosis in complete transposition. Circulation 1976; 54: 154159.CrossRefGoogle ScholarPubMed
7. Alampi, G, Frescura, C, Picchio, F, Gallucci, V, Thiene, G. Transposition of the great arteries: anatomic types of left ventricular outflow tract obstruction. G Ital Cardiol 1979; 9: 480487.Google Scholar
8. Silberbach, M, Castro, WL, Goldstein, MA, Lucas, RV, Edwards, JE. Comparison of types of pulmonary stenosis with the state of the ventricular septum in complete transposition of the great arteries. Pediatr Cardiol 1989; 10: 1115.CrossRefGoogle ScholarPubMed
9. Sansa, M, Tonkin, IL, Bargeron, LM, Elliott, LP. Left ventricular outflow tract obstruction in transposition of the great arteries: an angiographic study of 74 cases. Am J Cardiol 1979; 44: 8895.CrossRefGoogle ScholarPubMed
10. Elliott, LP, Neufeld, HN, Anderson, RC, Adams, P, Edwards, JE. Complete transposition of the great vessels – an anatomic study of sixty cases. Circulation 1963; 27: 11051117.CrossRefGoogle Scholar
11. Essed, C. Complete transposition – pathology and surgical options in prespective. Thesis Publishers, Amsterdam, 1996.Google Scholar
12. Crupi, G, Anderson, RH, Ho, SY, Lincoln, C, Buckley, MJ. Complete transposition of the great arteries with intact ventricular septum and left ventricular outflow tract obstruction. Surgical management and anatomic considerations. J Thorac Cardiovasc Surg 1979; 78: 730738.CrossRefGoogle ScholarPubMed
13. Crupi, G, Pillai, R, Parenzan, L, Lincoln, C. Surgical treatment of subpulmonary obstruction in transposition of the great arteries by means of a left ventricular-pulmonary arterial conduit. Late results and further considerations. J Thorac Cardiovasc Surg 1985; 89: 907913.CrossRefGoogle ScholarPubMed
14. Rastelli, GC, McGoon, DC, Wallace, RB. Anatomic correction of transposition of great arteries with ventricular septal defect and subpulmonary stenosis. J Thorac Cardiovasc Surg 1969; 58: 545552.Google Scholar
15. Dearani, JA, Danielson, GK, Puga, FJ, Mair, DD, Schleck, CD. Late results of the Rastelli operation for transposition of the great arteries. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2001; 4: 315.Google Scholar
16. Kreutzer, C, De Vive, J, Oppido, G, et al. Twenty-five-year experience with Rastelli repair for transposition of the great arteries. J Thorac Cardiovasc Surg 2000; 120: 211223.Google Scholar
17. Jatene, AD, Fontes, VF, Paulista, PP, Souza, LC, Neger, F, Galantier, M, Sousa, JE. Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg 1976; 72: 364370.CrossRefGoogle ScholarPubMed
18. Lecompte, Y, Neveux, JY, Leca, F, et al. Reconstruction of the pulmonary outflow tract without prosthetic conduit. J Thorac Cardiovasc Surg 1982; 84: 727733.CrossRefGoogle ScholarPubMed
19. Vouhé, PR, Tamisier, D, Leca, F, Ouaknine, R, Vernant, F, Neveux, JY. Transposition of the great arteries, ventricular septal defect, and pulmonary outflow tract obstruction. Rastelli or Lecompte procedure? J Thorac Cardiovasc Surg 1992; 103: 428436.Google Scholar
20. Lee, JR, Lim, HG, Kim, YJ, et al. Repair of transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction. Eur J Cardiothorac Surg 2004; 25: 735741.CrossRefGoogle ScholarPubMed
21. Nikaidoh, H. Aortic translocation and biventricular outflow tract reconstruction. A new surgical repair for transposition of the great arteries associated with ventricular septal defect and pulmonary stenosis. J Thorac Cardiovasc Surg 1984; 88: 365372.Google Scholar
22. Bex, JP, Lecompte, Y, Baillot, F, Hazan, E. Anatomical correction of transposition of the great arteries. Ann Thorac Surg 1980; 29: 8688.CrossRefGoogle ScholarPubMed
23. Metras, D, Kreitmann, B, Riberi, A, et al. Extending the concept of the autograft for complete repair of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction: a report of ten cases of a modified procedure. J Thorac Cardiovasc Surg 1997; 114: 746753.CrossRefGoogle ScholarPubMed
24. Losay, J, Touchot, A, Serraf, A, et al. Late outcome after arterial switch operation for transposition of the great arteries. Circulation 2001; 104 (1 Suppl): I121I126.CrossRefGoogle ScholarPubMed
25. Karl, TR, Cochrane, A, Brizard, CP. Arterial switch operation. Surgical solutions to complex problems. Tex Heart Inst J 1997; 24: 322333.Google ScholarPubMed
26. Sohn, YS, Brizard, CP, Cochrane, AD, Wilkinson, JL, Mas, C, Karl, TR. Arterial switch in hearts with left ventricular outflow and pulmonary valve abnormalities. Ann Thorac Surg 1998; 66: 842848.Google Scholar
27. Wernovsky, G, Jonas, RA, Colan, SD, et al. Results of the arterial switch operation in patients with transposition of the great arteries and abnormalities of the mitral valve or left ventricular outflow tract. J Am Coll Cardiol 1990; 16: 14461454.Google Scholar
28. Uemura, H, Yagihara, T, Kawashima, Y, et al. A bicuspid pulmonary valve is not a contraindication for the arterial switch operation. Ann Thorac Surg 1995; 59: 473476.Google Scholar
29. Kandeel, M, Kumar, N, Prabhakar, G, Halees, Z, Duran, CMG. Aortic translocation for D-TGA associated with LVOTO and VSD. Ann Thorac Surg 1995; 59: 515518.CrossRefGoogle ScholarPubMed
30. Morell, VO, Wearden, PD. Aortic translocation for the management of transposition of the great arteries with a ventricular septal defect, pulmonary stenosis, and hypoplasia of the right ventricle. Eur J Cardiothorac Surg 2007; 31: 552554.CrossRefGoogle ScholarPubMed
31. Yeh, T, Ramaciotti, C, Leonard, SR, Roy, L, Nikaidoh, H. The aortic translocation (Nikaidoh) procedure: Midterm results superior to the Rastelli procedure. J Thorac Cardiovasc Surg 2007; 133: 461469.Google Scholar
32. Bautista-Hernandez, V, Marx, GR, Bacha, EA, del Nido, PJ. Aortic root translocation plus arterial switch for transposition of the great arteries with left ventricular outflow tract obstruction: intermediate-term results. J Am Coll Cardiol 2007; 49: 485490.Google Scholar
33. Yacoub, MH, Radley-Smith, R. Anatomy of the coronary arteries in transposition of the great arteries and methods for their transfer in anatomical correction. Thorax 1978; 33: 418424.Google Scholar
34. Gittenberger de Groot, AC, Sauer, U, Oppenheimer-Dekker, A, Quaegebeur, J. Coronary arterial anatomy in transposition of the great arteries: a morphologic study. Pediatr Cardiol 1983; 4: 1524.Google Scholar
35. Lacour-Gayet, F, Anderson, RH. A uniform surgical technique for transfer of both simple and complex patterns of the coronary arteries during the arterial switch procedure. Cardiol Young 2005; 15: 93101.Google Scholar
36. Legendre, A, Losay, J, Touchot-Koné, A, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation 2003; 108 (1 Suppl): II186II190.Google Scholar
37. Wernovsky, G, Mayer, JE Jr, Jonas, RA, et al. Factors influencing early and late outcome of the arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg 1995; 109: 289301.Google Scholar
38. Legendre, A, Losay, J, Touchot-Kone, A, et al. Prevalence and diagnosis of coronary lesions after arterial switch. Arch Mal Coeur Vaiss 2003; 96: 485488.Google ScholarPubMed
39. Bonhoeffer, P, Bonnet, D, Piéchaud, JF, et al. Coronary artery obstruction after the arterial switch operation for transposition of the great arteries in newborns. J Am Coll Cardiol 1997; 29: 202206.CrossRefGoogle ScholarPubMed
40. Hutter, PA, Bennink, GB, Ay, L, Raes, IB, Hitchcock, JF, Meijboom, EJ. Influence of coronary anatomy and reimplantation on the long-term outcome of the arterial switch. Eur J Cardiothorac Surg 2000; 18: 207213.Google Scholar
41. Scheule, AM, Zurakowski, D, Blume, ED, et al. Arterial switch operation with single coronary artery. J Thorac Cardiovasc Surg 2002; 123: 11641172.Google Scholar
42. Pasquali, SK, Hasselblad, V, Li, JS, Kong, DF, Sanders, SP. Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation 2002; 106: 25752580.CrossRefGoogle ScholarPubMed
43. Sarris, GE, Chatzis, AC, Giannopoulos, NM, et al. European Congenital Heart Surgeons Association. The arterial switch operation in Europe for transposition of the great arteries: A multi-institutional study from the European Congenital Heart Surgeons Association. J Thorac Cardiovasc Surg 2006; 132: 633639.Google Scholar
44. Massoudy, P, Baltalarli, A, de Leval, MR, et al. Anatomic variability in coronary arterial distribution with regard to the arterial switch procedure. Circulation 2002; 106: 19801984.Google Scholar