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In most cases, the coronary implantation sites will be at left and right anterior positions at the base of the neo-aorta; however, if the circumflex coronary artery branches from the right coronary artery, the circumflex coronary artery will be distorted if the pair are not implanted higher than normal on the neo-aorta, and in some cases they may need to be implanted above the aortic commissure, on the native aorta itself. This would have effectively reduced early mortality rates, particularly in cases with no concomitant shunts, but is unlikely to have reduced late mortality rates. Post-operative[edit]. The vessels are again examined, and the pulmonary root is inspected for left ventricular outflow tract obstruction (LVOTO). A blood transfusion is necessary for the arterial switch because the HLM needs its "circulation" filled with blood and an infant does not have enough blood on their own to do this (in most cases, an adult would not require blood transfusion).
Approximately 10% of arterial switch recipients develop residual pulmonary stenosis post-operatively, which can lead to right heart failure if left untreated; treatment usually involves endovascular stenting and/or xenograft patching. Overview[edit]. This procedure yielded early and late mortality rates comparable to the Senning procedure; however, a late morbidity rate was eventually discovered in relation to the use of synthetic graft material, which does not grow with the recipient and eventually causes obstruction. The aortic clamp is temporarily removed while small sections of the neo-aorta are cut away to accommodate the coronary ostia, and a continuous absorbable suture is then used to anastomose each coronary "button" into the prepared space. It was the first method of d-TGA repair to be attempted, but the last to be put into regular use because of technological limitations at the time of its conception. DOWNLOAD FILE. History[edit]. Cirurgia de jatene pdf download.
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