Department of Pediatric Cardiac Surgery, 386529Fortis Memorial Research Institute, Gurgaon, India.
Department of Pediatric Cardiac Surgery, 29092Apollo Children's Hospital, Chennai, India.
Asian Cardiovasc Thorac Ann. 2022 Oct;30(8):916-923. doi: 10.1177/02184923221120751. Epub 2022 Aug 15.
Transposition of great arteries with ventricular septal defect and pulmonary stenosis is a complex congenital cardiac malformation with varied treatment options. Double root translocation is one of the described techniques with several advantages over other techniques. Our goal of this study is to report our early experiences on the performance of translocated aortic and pulmonary root.
From 2016 to 2019, a total of 12 patients (seven boys and five girls) aged from one year to three years underwent double root translocation. All our patients were diagnosed with dextro-transposition of the great arteries (d-TGA)/double-outlet right ventricle (DORV), ventricular septal defect (VSD), and pulmonary stenosis (PS). One patient (8.33%) presented with (IL 2R CX), remaining 11 patients (91.66%) had (IL CX 2R) as their coronary pattern. Mean follow-up period was two years (1-3 years).
At six months follow up, one patient died due to severe MR, one patient had severe TR and was taken back for surgery after two weeks post-surgery. Three patients had trivial aortic regurgitation (AR) and nine had no AR, two patients had trivial mitral regurgitation (MR) and 10 had no MR 11 patients had post-operative sinus rhythm and were in NYHA class 1. One patient with a complete heart block was supported with extracorporeal membrane oxygenator followed by tracheostomy. Redo TV repair was done in one patient. Peritoneal dialysis was accomplished in two patients.
Double root translocation is a good alternative surgical treatment for TGA/DORV, VSD, and PS, where the pulmonary valve is small, but the leaflets are usable. Although the operation is technically demanding, our early follow-up on translocated root performance shows promising outcomes.
大动脉转位合并室间隔缺损和肺动脉瓣狭窄是一种复杂的先天性心脏畸形，有多种治疗选择。双根部移位是一种已描述的技术，与其他技术相比具有多个优势。我们的研究目的是报告我们在进行主动脉和肺动脉根部移位方面的早期经验。
2016 年至 2019 年，共有 12 名年龄在 1 至 3 岁的患者（7 名男孩和 5 名女孩）接受了双根部移位。所有患者均被诊断为大动脉转位（d-TGA）/双出口右心室（DORV）、室间隔缺损（VSD）和肺动脉瓣狭窄（PS）。一名患者（8.33%）存在（IL 2R CX），其余 11 名患者（91.66%）存在（IL CX 2R）的冠状动脉模式。平均随访时间为 2 年（1-3 年）。
在 6 个月的随访中，1 名患者因严重二尖瓣反流（MR）死亡，1 名患者在手术后两周因严重三尖瓣反流（TR）再次手术。3 名患者有轻微的主动脉瓣反流（AR），9 名患者无 AR；2 名患者有轻微的二尖瓣反流（MR），10 名患者无 MR；11 名患者术后为窦性心律，NYHA 心功能分级为 1 级。1 名完全性心脏传导阻滞的患者接受了体外膜肺氧合支持，随后进行了气管造口术。1 名患者再次进行了三尖瓣修复术。2 名患者进行了腹膜透析。
对于肺动脉瓣较小但瓣叶可利用的 TGA/DORV、VSD 和 PS，双根部移位是一种良好的替代手术治疗方法。虽然手术技术要求较高，但我们对根部移位性能的早期随访结果显示出了有前景的结果。
