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Aortic translocation, Senning procedure and right ventricular outflow tract augmentation for congenitally corrected transposition, ventricular septal defect and pulmonary stenosis

^a Cardiac Surgical Unit, Royal Children's Hospital, Melbourne, Australia
^b Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
^c Department of Paediatrics, University of Melbourne, Melbourne, Australia

Received 3 October 2006; received in revised form 20 January 2008; accepted 30 January 2008.

^_* Corresponding author. Address: Cardiac Surgical Unit, Royal Children's Hospital, Flemington Road, Melbourne, VIC 3052, Australia. Tel.: +61 3 9345 5200; fax: +61 3 9345 6386. (Email: christian.brizard{at}rch.org.au).

The management of congenitally corrected transposition of the great arteries and associated lesions is frequently challenging. Significant pulmonary stenosis is a contraindication to the conventional double-switch. Instead repair may be accomplished by the Rastelli–Senning procedure, using an extracardiac conduit to achieve continuity between the morphological left ventricle and the pulmonary arteries. This however can be accompanied by conduit and intra-ventricular baffle-related problems that can necessitate surgical re-intervention and lead to late mortality. We describe the use of aortic translocation, Senning procedure and reconstruction of the right ventricular outflow tract using autologous tissue and valved homograft to facilitate anatomical correction in congenitally corrected transposition. The advantages of this technique in this group of patients and the implications for conduction tissue are discussed.

Key Words: Congenital heart disease (CHD) • Congenitally corrected transposition of the great arteries • Heart surgery