18732 Caputo.mp4 (1.17 GB)

Double Switch Operation for Congenitally Corrected Transposition of the Great Arteries and Ventricular Septal Defect

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posted on 2022-12-12, 20:55 authored by M Caputo, R Capoun, M Sandhu, D Wilson, SA Narayan, M Kostonly

This video presents surgical details of the double switch operation, consisting of ventricular septal defect (VSD) closure, Senning, and arterial switch procedures in a five-year-old boy. The patient had previously undergone pulmonary artery (PA) banding at two months of age. Preoperative investigation consisted of an echocardiography, angiogram, and cross-imaging data (MRI and CT scan) in order to assess the indication to the double switch operation. 

Preoperative data showed adequate thickness and contractility of the left ventricle, trivial atrioventricular valve regurgitation, atrioventricular and ventriculo-arterial discordance with L loop arrangement, and the aorta lying anteriorly and to the left of the pulmonary artery. The right-sided coronary artery was arising from the anterior facing sinus and the left-side coronary artery from the posterior facing sinus.

The surgical procedure consisted of an atrial switch Senning procedure using the patient's own tissue to create the baffles, a VSD closure with bovine pericardial patch, and an arterial switch operation with the LeCompte maneuver.

The postoperative hemodynamic and echocardiographic data were very satisfactory, and the patient made an uneventful recovery.


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