Department of Pediatric Cardiac Surgery, Clinic for Thoracic and Cardiovascular Surgery, Kepler University Hospital, Linz, Austria; Medical Faculty, Johannes Kepler University, Linz, Austria.
Department of Pediatric Cardiac Surgery, Clinic for Thoracic and Cardiovascular Surgery, Kepler University Hospital, Linz, Austria; Medical Faculty, Johannes Kepler University, Linz, Austria.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2024;27:63-68. doi: 10.1053/j.pcsu.2024.01.008. Epub 2024 Jan 23.
En bloc rotation of the outflow tracts or double root translocation offers an anatomic repair of transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction and closely related forms of double outlet right ventricle. The technical principle is to excise aortic and pulmonary root en bloc, rotate them as a whole by 180°, and reimplant them. The left ventricular outflow tract is enlarged with the patch closing the ventricular septal defect. In our experience, two thirds of the pulmonary valves could be preserved. Growth of the aortic and pulmonary root could be demonstrated in several studies performed by our group. It is still a complex and technically demanding procedure with long cardiopulmonary bypass periods and cross-clamp times. However, perioperative mortality and complications do not differ significantly from other forms of reconstruction. The reoperation rate is significantly lower. Presently, the best time to perform this operation seems to be after the newborn period within the first year of life.
流出道整块旋转或双根部转位为大动脉转位、室间隔缺损和左心室流出道梗阻以及密切相关的双出口右心室提供了一种解剖修复方法。技术原理是整块切除主动脉和肺动脉根部，将其整体旋转 180°，并重新植入。用补片关闭室间隔缺损来扩大左心室流出道。根据我们的经验，三分之二的肺动脉瓣可以保留。我们小组进行的几项研究表明，主动脉和肺动脉根部可以生长。它仍然是一种复杂且技术要求高的手术，需要长时间的心肺转流和阻断时间。然而，围手术期死亡率和并发症与其他重建形式没有显著差异。再次手术率明显较低。目前，进行此手术的最佳时间似乎是新生儿期后 1 年内。
