En-bloc Rotation of the Truncus Arteriosus-A Technique for Complete Anatomic Repair of Transposition of the Great Arteries /Ventricular Septal Defect/Left Ventricular Outflow Tract Obstruction or Double Outlet Right Ventricle/Left Ventricular Outflow Tract Obstruction

摘要

The Rastelli procedure has been traditionally used for re pair of transposition of the great arteries (TGA) wit] ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO), or double outlet right ventricl with subpulmonary VSD and LVOTO.1 The Rastelli proce dure in its original version involves an intracardiac baffle which forms the left ventricular outflow tract from the VSD t< the aortic valve. This results in a long intracardiac tunnel an< has an inherent tendency to obstruction. A homograft o xenograft is also needed for reconstruction of the right ven tricular outflow tract. Resection of the conal septum an< direct anastomosis between the main pulmonary artery an< the right ventricle as in the Lecompte procedure,2 or repara tion a l'etage ventriculaire (REV), can minimize these prob lems but does not completely solve them. Although there i growth potential in the pulmonary artery after a REV proce dure, there is no valve in the right ventricular outflow trad Therefore, one can expect similar problems as follow tetral ogy repair with a transannular patch.