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J Thorac Cardiovasc Surg 2005;130:593-594
© 2005 The American Association for Thoracic Surgery

Brief Communication

Intraventricular rerouting for transposition of the great arteries with posterior aorta: Ventricular septal defect creation and total resection of the infundibular septum

Nobuyuki Ishibashi, MD a , * , Mitsuru Aoki, MD a , Manabu Watanabe, MD a , Hiromichi Nakajima, MD b , Hiroyuki Aotsuka, MD b , Tadashi Fujiwara, MD a

a Department of Cardiovascular Surgery, Chiba Children’s Hospital, Chiba, Japan
b Department of Cardiology, Chiba Children’s Hospital, Chiba, Japan

Received for publication January 12, 2005; accepted for publication January 18, 2005.

* Address for reprints: Nobuyuki Ishibashi, MD, Department of Cardiovascular Surgery, Chiba Children’s Hospital, 579-1 Heta-cho, Midori-ku, Chiba-shi, Chiba 266-0007, Japan (Email: nobishibashi-ths@umin.ac.jp).

The first 20% of the full text of this article appears below.

Atypical transposition of the great arteries (TGA), in which the aorta was situated posteriorly and the pulmonary artery (PA) was situated anteriorly, was reported in 1971. 1 Go In this TGA with a posterior aorta, the aorta rises from the right ventricle (RV) but retains fibrous aortic-mitral continuity, and the PA arises from a muscular conus above the left ventricle (LV). 1,2 Go The principal surgical options are arterial or atrial switch combined with the ventricular septal defect (VSD) closure. 3,4 Go In this anomaly, the VSD assumes a slit form, and the infundibular septum (IS) interferes with the LV-aorta route by the good alignment of the IS and the intraventricular septum (Figure 1, A), which makes the biventricular repair with intraventricular rerouting difficult in cases with pulmonary stenosis (PS).


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  		Figure 1. Schematic illustration of intraventricular rerouting by VSD creation and total resection of the infundibular septum. A, Before surgery. B, After surgery. Ao, Aortic valve; Pu, pulmonary valve; M, mitral valve; T, tricuspid valve; IS, infundibular septum; 1, LV outflow patch; 2, RV outflow patch; A, anterior; P, posterior; L, left; R, right.

 
We performed intraventricular rerouting by subpulmonary VSD creation and total resection of the . . . [Full Text of this Article]






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