Abstract
Aortic insufficiency sometimes occurs after arterial switch operation for transposition of the great arteries. Left ventricular outflow tract enlargement by Konno operation and right ventricular outflow tract reconstruction are necessary during the aortic valve replacement in case of small aortic annulus. A vertical incision from the anterior pulmonary artery to the right ventricular outflow tract in Konno operation can be applied if the coronary anatomy is Shaher type 1, 2, 6, and 8. However, a vertical incision jeopardizes the coronary artery which traverses on the right ventricular outflow tract in Shaher type 3a, 3c, 3d, 4, 5c, 7c, and 9. In this difficult situation, atrioventricular groove patch plasty as part of Konno operation is a choice of surgery.
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