The aortic translocation (Nikaidoh) procedure: Initial experience

Abstract

Objective Midterm follow-up is analyzed after the aortic translocation (Nikaidoh) procedure, an alternative to the Rastelli procedure for ventriculoarterial discordance, ventricular septal defect, and pulmonary stenosis especially in cases with small or inlet VSD. Methods Seven patients underwent a Nikaidoh procedure at a median age of 3.3 years (0.9–9.3 years). The native aortic valve was translocated from the right to the left ventricular outflow tract by mobilization of the aortic root.Four patients with coronary transfer as the right coronary artery reimplanted as a button while the other three patients had no coronary transfer. The conal septum was divided in all patients. The right ventricular outflow tract was reconstructed with valved conduit. The median follow-up was 18 months (0.3–4 years). Left ventricular outflow tract obstruction and aortic insufficiency were assessed by echocardiography. Results There were no deaths. Right ventricular to Pulmonary artery conduit change were required in 2 patients (28.6%). No patient had any left ventricular outflow tract obstruction or aortic insufficiency more than mild. All patients are doing well at last follow up. Conclusion The Nikaidoh is a valid alternative to Rastelli or REV operations. It appears particularly indicated in patients with TGA,VSD and LV outflow obstruction with small or inlet VSD.