A simple technique to circumvent the aorto-pulmonary size mismatch in arterial switch operation with arch repair: a report of five cases

Abstract

The discrepancy in the sizes of the aorta and the pulmonary artery is a major technical concern in arterial switch operations for transposition of great arteries with ventricular septal defect, arch hypoplasia/interruption and Taussig Bing anomaly. The size mismatch increases the difficulty in neoaortic reconstruction and securing hemostasis. It alters the Sino tubular anatomy and contributes to development of Neoaortic Regurgitation (NAR). We present five cases of successful repairs for Transposition of Great Arteries (TGA) with hypoplastic transverse arch and Coarctation where the extended homologous gluteraldehyde treated pericardial patch was used to augment the isthmus, transverse arch and the ascending aorta upto the line of transaction to avoid the aorto-pulmonary size mismatch.