What question did this study set out to answer?

Detail the surgical technique and clinical outcomes of an arterial switch operation and multi-hole ventricular septal defect closure utilizing integrated extracorporeal membrane oxygenation.

September 21, 2023Journal of Cardiac Critical Care TSSOpen Access

Anatomical Correction of Transposition of the Great Arteries at the Arterial Level with Dacron Patch Closure of Multiple Ventricular Septal Defects under Integrated Extracorporeal Membrane Oxygenation: A Video Presentation

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Detail the surgical technique and clinical outcomes of an arterial switch operation and multi-hole ventricular septal defect closure utilizing integrated extracorporeal membrane oxygenation.
Performed an arterial switch operation and Dacron patch closure of multiple muscular ventricular septal defects in a 5-week-old male infant (weight: 4 kg) with d-transposition of the great arteries and Yacoub type-A coronary anatomy.
Employed moderately hypothermic cardiopulmonary bypass, St. Thomas-based cold blood cardioplegia, and an integrated extracorporeal membrane oxygenation (ECMO) circuit.
Required post-surgical mechanical circulatory support via ECMO for 72 hours before successful weaning.
Demonstrated preserved biventricular function, a Ross clinical score of 2, and absence of neoaortic, mitral, or tricuspid valve regurgitation at 12 months of follow-up.

Structured PICO

Population

1 male child, 5 weeks old, weighing 4 kg, diagnosed with d-transposition of the great arteries with multiple muscular ventricular septal defects and Yacoub’s type-A coronary arterial pattern.

Intervention

Arterial switch operation with Dacron patch closure of ventricular septal defects under moderately hypothermic cardiopulmonary bypass and St. Thomas based cold blood cardioplegia under integrated extracorporeal membrane oxygenation.

Outcome

Clinical and echocardiographic outcomes at 12 months of follow-up (valvular regurgitation, biventricular function, Ross clinical score).

Arterial switch operation with Dacron patch closure of multiple VSDs under integrated ECMO was successfully performed in a 5-week-old infant with d-TGA, yielding good 12-month outcomes.

Discussion

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Implication

Supports ECMO-assisted neonatal d-TGA repair in select cases; hypothesis-generating, requires prospective validation before practice change.

Cite This Study

Chowdhury et al. (2023) studied this question.

synapsesocial.com/papers/69dd5e077808b00a4799d387 https://doi.org/10.25259/jccc_37_2023

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Implication

Supports ECMO-assisted neonatal d-TGA repair in select cases; hypothesis-generating, requires prospective validation before practice change.

Anatomical Correction of Transposition of the Great Arteries at the Arterial Level with Dacron Patch Closure of Multiple Ventricular Septal Defects under Integrated Extracorporeal Membrane Oxygenation: A Video Presentation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Anatomical Correction of Transposition of the Great Arteries at the Arterial Level with Dacron Patch Closure of Multiple Ventricular Septal Defects under Integrated Extracorporeal Membrane Oxygenation: A Video Presentation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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