Two cases of double outlet right ventricle with subpulmonary ventricular septal defect
treated by arterial switch Operations are reported. The anatomical problems of coronary
artery transfer, occult outflow tract obstruction and position of the pulmonary bifurcation
are discussed. Cases of double outlet right ventricle and subpulmonary ventricular
septal defect with anterior-to-posterior relation of the great arteries are suited
to the repair techniques pioneered by Jatene for com- plete transposition and ventricular
septal defect. Cases in which the great arteries are side-by-side pose more difficult
Problems, partly because of the more cornplex and varied anatomy of the coronary arteries,
and because of the spatial relation of the roots of the great arteries. Although it
may be possible to overcome these technical problems, we have reservations about the
reproducibility of such a procedure. We believe, however, that cases of this type
are best treated without recourse to “inflow” correction. The options are either the
arterial switch procedure or a modified Rastelli operation.
Cardiac surgery - Congenital heart disease - Double outlet ventricle - Arterial switch
