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◙◙ Introduction 2
◙◙ Anatomy 3
◙◙ Complete Transposition of the Great Arteries,
with or without Ventricular Septal Defect 5
◙◙ Indication for Surgery 5
◙◙ Approach and Cardiopulmonary Bypass Strategy 5
◙◙ Arterial Switch Operation 6
◙◙ The Goal of Surgery 6
◙◙ Arterial Switch Operation in Simple Transposition with
a Coronary Pattern (1AD; 2R, Cx) 6
◙◙ Patient Characteristics 6
◙◙ Specific Steps of Operation 7
◙◙ Arterial Switch Operation in Situs Inversus
with a Coronary Pattern (1R; 2AD, Cx) 13
◙◙ Patient Characteristics 13
◙◙ Specific Steps of Operation 14
◙◙ Arterial Switch Operation with a Coronary Pattern (1R; AD, Cx) 20
◙◙ Patient Characteristics 20
◙◙ Specific Steps of Operation 21
◙◙ Arterial Switch Operation with a Coronary Pattern (2R; AD, Cx) 24
◙◙ Patient Characteristics 24
◙◙ Specific Steps of Operation 24
◙◙ Arterial Switch Operation in Complex Transposition with Crisscross Heart,
Multiple Ventricular Septal Defects, Straddling of Tricuspid Valve, Mild Subvalvar
and Valvar Pulmonary Stenosis, and with a Coronary Pattern (1Cx; 2R, AD) 26
◙◙ Patient Characteristics 26
◙◙ Specific Steps of Operation 27
◙◙ Complete Transposition of the Great Arteries with Ventricular Septal
Defect and Left Ventricular Outflow Tract Obstruction 35
◙◙ Indication for Surgery 35
◙◙ Approach and Cardiopulmonary Bypass Strategy 35
◙◙ REV (Réparation à l’étage ventriculaire) Operation 36
◙◙ The Goal of Surgery 36
◙◙ Patient Characteristics 37
◙◙ Specific Steps of Operation 37
Back
◙◙ Bex–Nikaidoh Procedure 43
◙◙ The Goal of Surgery 43
◙◙ Patient Characteristics 44
◙◙ Specific Steps of Operation 44
◙◙ Recommended Reading 51
◙◙ Introduction 54
◙◙ Anatomy 55
◙◙ Ventricular Septal Defect 57
◙◙ Conduction System 57
◙◙ Coronaries 58
◙◙ Anatomical Correction of Corrected Transposition of the Great Arteries 59
◙◙ Indication for Anatomical Correction 59
◙◙ Approach and Cardiopulmonary Bypass Strategy 60
◙◙ Modified Senning Operation 61
◙◙ The Goal of Surgery 61
◙◙ Modified Half-Mustard Operation 62
◙◙ The Goal of Surgery 62
◙◙ Arterial Switch Operation for Corrected Transposition of the Great Arteries 62
◙◙ The Goal of Surgery 62
◙◙ Rastelli Operation for Corrected Transposition of the Great Arteries 62
◙◙ The Goal of Surgery 62
◙◙ Bex–Nikaidoh Procedure for Corrected Transposition of the Great Arteries 63
◙◙ The Goal of Surgery 63
◙◙ Double Switch Operation for Corrected Transposition of the Great Arteries {SLL},
with Resection of the Subpulmonary Obstruction in Situs Solitus and Levocardia 64
◙◙ Patient Characteristics 64
◙◙ Specific Steps of Operation 64
◙◙ Closure of the Ventricular Septal Defect During the Double Switch Procedure 73
◙◙ Senning–Rastelli Operation for Corrected Transposition of the Great Arteries {SLL}
with Ventricular Septal Defect, Pulmonary Atresia, and Dextrocardia 74
◙◙ Patient Characteristics 74
◙◙ Specific Steps of Operation 74
◙◙ Senning–Rastelli Operation for Corrected Transposition of the Great
Arteries {IDD} with Noncommitted Ventricular Septal Defect,
Pulmonary Stenosis, Situs Inversus, and Levocardia 79
◙◙ Patient Characteristics 79
◙◙ Specific Steps of Operation 79
◙◙ Modified Half-Mustard and Rastelli Operation for Corrected Transposition
of the Great Arteries {SLL} in Situs Solitus with Dextrocardia 85
Contents XIII
Back
◙◙ Patient Characteristics 85
◙◙ Specific Steps of Operation 85
◙◙ Modified Senning and Bex–Nikaidoh Procedure for Corrected
Transposition of the Great Arteries {IDD} with an Inlet Ventricular
Septal Defect in Situs Inversus and Mesocardia 87
◙◙ Patient Characteristics 87
◙◙ Specific Steps of Operation 88
◙◙ Recommended Reading 92
◙◙ Introduction 95
◙◙ Aortic Stenosis in Neonates and Infants 95
◙◙ Anatomy 95
◙◙ Indication for Surgery 96
◙◙ Approach and Cardiopulmonary Bypass Strategy 96
◙◙ Open Valvotomy for Critical Aortic Stenosis in the Newborn 97
◙◙ The Goal of Surgery 97
◙◙ Patient Characteristics 97
◙◙ Specific Steps of Surgery 97
◙◙ Aortic Stenosis in Children 101
◙◙ Anatomy 101
◙◙ Indication for Surgery 101
◙◙ Approach and Cardiopulmonary Bypass Strategy 101
◙◙ The Goal of Surgery 102
◙◙ Aortic Insufficiency in Children 102
◙◙ Anatomy 102
◙◙ Indication for Surgery 103
◙◙ Approach and Cardiopulmonary Bypass Strategy 103
◙◙ The Goal of Surgery 104
◙◙ Subcommissural Downsizing of the Aortic Annulus,
with Asymmetric Resection of the Sinus Valsalva 107
◙◙ Patient Characteristics 107
◙◙ Specific Steps of Surgery 107
◙◙ Resection of the Subaortic Membrane and Pericardial
Patch Augmentation of the Aortic Valve 109
◙◙ Patient Characteristics 109
◙◙ Specific Steps of Surgery 109
◙◙ Aortic Valve Reconstruction with Pericardial Extensions, Resection of the
Subaortic Membrane, and Closure of the Aneurysm of the Sinus Valsalva 111
◙◙ Patient Characteristics 111
◙◙ Specific Steps of Surgery 112
XIV V. Hraška, P. Murín
Back
◙◙ Tricuspidalization of the Unicuspid Aortic Valve – Reconstruction
of Two Cusps with the Native Tissue and Creation of the
Remaining Cusp Using Autologous Pericardium 115
◙◙ Patient Characteristics 115
◙◙ Specific Steps of Surgery 115
◙◙ Reconstruction of an Aortic Valve Destroyed by Bacterial
Endocarditis – Closure of an Abscess Formation Invading the Annulus
of the Aortic Valve and Anterior Leaflet of the Mitral Valve 118
◙◙ Patient Characteristics 118
◙◙ Specific Steps of Surgery 119
◙◙ Ross Operation 120
◙◙ The Goal of Surgery 120
◙◙ Patient Characteristics 120
◙◙ Specific Steps of Surgery 120
◙◙ Subvalvar Aortic Stenosis 127
◙◙ Introduction 127
◙◙ Anatomy 127
◙◙ Indication for Surgery 128
◙◙ Approach and Cardiopulmonary Bypass Strategy 129
◙◙ Resection of a Discrete Subaortic Membrane 129
◙◙ The Goal of Surgery 129
◙◙ Patient Characteristics 129
◙◙ Specific Steps of Surgery 130
◙◙ Ross–Konno Operation with Resection of Endocardial
Fibroelastosis in the Infant 132
◙◙ The Goal of Surgery 132
◙◙ Patient Characteristics 133
◙◙ Specific Steps of Surgery 134
◙◙ Supravalvar Aortic Stenosis 141
◙◙ Introduction 141
◙◙ Anatomy 141
◙◙ Indication for Surgery 142
◙◙ Approach and Cardiopulmonary Bypass Strategy 142
◙◙ Symmetric Three-Patch Technique with Central Pulmonary Artery Plasty 142
◙◙ The Goal of Surgery 142
◙◙ Patient Characteristics 143
◙◙ Specific Steps of Surgery 143
◙◙ Symmetric Nonpatch Technique (Myer’s) 148
◙◙ The Goal of Surgery 148
◙◙ Patient Characteristics 148
◙◙ Specific Steps of Surgery 148
◙◙ Recommended Reading 149
Contents XV
Back
4 Tetralogy of Fallot 151
◙◙ Introduction 152
◙◙ Tetralogy of Fallot with Pulmonary Stenosis 153
◙◙ Anatomy 153
◙◙ Indication for Surgery 154
◙◙ Approach and Cardiopulmonary Bypass Strategy 154
◙◙ Transatrial Approach with Release of the Right
Ventricular Outflow Tract Obstruction 154
◙◙ The Goal of Surgery 154
◙◙ Patient Characteristics 155
◙◙ Specific Steps of Operation 155
◙◙ Transatrial Approach with Resection of the Right Ventricular
Outflow Tract and Valvotomy of the Pulmonary Valve 159
◙◙ The Goal of Surgery 159
◙◙ Patient Characteristics 159
◙◙ Specific Steps of Operation 159
◙◙ Transatrial Approach with a Mini-Transannular Patch 160
◙◙ The Goal of Surgery 160
◙◙ Patient Characteristics 160
◙◙ Specific Steps of Operation 161
◙◙ Tetralogy of Fallot with Pulmonary Atresia and Ductus-
Dependent Pulmonary Circulation 164
◙◙ Anatomy 164
◙◙ Indication for Surgery 164
◙◙ Transventricular Approach Preserving the Natural Connection of the Right Ventricle
and Pulmonary Artery with Patch Enlargement of the Outflow Tract 164
◙◙ The Goal of Surgery 164
◙◙ Patient Characteristics 165
◙◙ Specific Steps of Operation 165
◙◙ Direct Connection of the Pulmonary Artery and Right Ventriculotomy
with Patch Enlargement of the Outflow Tract 168
◙◙ The Goal of Surgery 168
◙◙ Patient Characteristics 168
◙◙ Specific Steps of Operation 169
◙◙ Tetralogy of Fallot with Absent Pulmonary Valve Syndrome 173
◙◙ Anatomy 173
◙◙ Indication for Surgery 173
◙◙ Technique of Anterior Translocation of the Pulmonary Artery 173
◙◙ The Goal of Surgery 173
◙◙ Patient Characteristics 174
◙◙ Specific Steps of Operation 174
◙◙ Recommended Reading 181
XVI V. Hraška, P. Murín
Back
5 Ebstein’s Anomaly 183
◙◙ Introduction 184
◙◙ Anatomy 184
◙◙ Indication for Surgery 185
◙◙ Newborns and Young Infants 185
◙◙ Older Patients 185
◙◙ Approach and Cardiopulmonary Bypass Strategy 186
◙◙ Anatomical Repair – Cone Reconstruction 186
◙◙ The Goal of Surgery 186
◙◙ Cone Reconstruction with Longitudinal Plication
of the Atrialized Ventricle in the Newborn 188
◙◙ Patient Characteristics 188
◙◙ Specific Steps of Operation 188
◙◙ Cone Reconstruction with Longitudinal Plication
of the Atrialized Ventricle in the Infant 194
◙◙ Patient Characteristics 194
◙◙ Specific Steps of Operation 194
◙◙ Cone Reconstruction without Plication of the Atrialized Ventricle 196
◙◙ Patient Characteristics 196
◙◙ Specific Steps of Operation 196
◙◙ Recommended Reading 201