Arterial Switch Lab Report

The arterial switch was conducted as per our previously published technique (4) under moderate hypothermia and blood cardioplegia given through the aortic root or through the coronary ostia. Except for 3 patients where the VSD was closed through a right ventriculotomy, all the other TBA patients underwent VSD closure through the right atrium. In the TGA VSD group, once again, the right atrial approach was most commonly employed.8 patients, with subaortic location of VSD underwent closure working through the transected aorta after coronary button harvesting. Any excess musculature in the right ventricular outlet was avidly searched for through the aorta and excised to preempt future subpulmonary obstruction. Defects created in the neopulmonary root after coronary button excision were filled by a generous patch of autologous pericardium. A lecompte maneuver was performed in all the arterial switches.
Attention was also paid to both the arterial waveforms. In the presence of a PDA, the above two were again taken into account after PDA ligation. Isolated aortic arch hypoplasia without any pressure difference between the upper and lower limbs was left untouched.
In 8 patients of TBA (26%) and 6 patients of TGA VSD (11%), with a preoperative arch gradient, the surgical procedure included concomitant aortic arch repair
Our approach to AAO was to correct it at the same time as the arterial switch operation. Whenever this had to be carried out, deep hypothermia with total circulatory arrest or, for the last 3 years, isolated innominate artery perfusion thru a graft was utilized. One of two methods were utilized for treating the arch