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The Nikaidoh procedure for complex transposition of the great arteries: short-term follow-up

Published online by Cambridge University Press:  14 November 2016

Guillermo Ventosa-Fernández*
Affiliation:
Cardiovascular Surgery Department, Clinic Hospital of Barcelona, Universidad de Barcelona, Barcelona, Spain
Carolina Pérez-Negueruela
Affiliation:
Cardiovascular Surgery Department, San Joan de Deu Hospital, Barcelona, Spain
Javier Mayol
Affiliation:
Cardiovascular Surgery Department, San Joan de Deu Hospital, Barcelona, Spain
Marina Paradela
Affiliation:
Thoracic Surgery Department, Clinic Hospital of Barcelona, Barcelona University, Barcelona, Spain
José M. Caffarena-Calvar
Affiliation:
Cardiovascular Surgery Department, San Joan de Deu Hospital, Barcelona, Spain
*
Correspondence to: G. Ventosa-Fernández, Cirugia Cardiovascular, Hospital Clinic Barcelona, Villarroel 170, 08036 Barcelona, Spain. Tel: +34 65 260 76 44; Fax: +34 92 227 57 49; E-mail: guillermo_ventosa@hotmail.com

Abstract

Background

The surgical treatment for complex forms of d-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction remains controversial. In this study, we describe the classical surgical options – namely, the Rastelli procedure and the “réparation à l’étage ventriculaire” – and present our experience with the modified Nikaidoh procedure with early and short-term follow-up results.

Methods

Between 2007 and 2014, four patients with d-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction underwent surgical repair at our institution by means of a modified Nikaidoh procedure.

Results

With a mean follow-up of 4.5 years, survival was 100%, and none of the patients required re-intervention or mechanical circulatory support. There was no recurrence of left ventricular outflow tract obstruction and no aortic valve regurgitation classified as more than mild. Left ventricular function was preserved.

Conclusions

Aortic translocation with the modified Nikaidoh procedure is a safe and effective surgical treatment for certain complex forms of transposition of the great arteries, particularly those associated with ventricular septal defect and left ventricular outflow tract obstruction. It is associated with less need for re-intervention and better morbidity and mortality results in the short- and mid-term follow-up, when compared with the classical alternatives such as the Rastelli procedure.

Type
Original Articles
Copyright
© Cambridge University Press 2016 

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References

1. Hazekamp, MG, Gomez, AA, Koolbergen, DR, et al. Surgery for transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction: European Congenital Heart Surgeons Association multicentre study. Eur J Cardiothorac Surg 2010; 38: 699706.Google Scholar
2. Rastelli, GC, Wallace, RB, Ongley, PA. Complete repair of transposition of the great arteries with pulmonary stenosis: a review and report of a case corrected by using a new surgical technique. Circulation 1969; 39: 8395.Google Scholar
3. Horer, J, Schreiber, C, Dworak, E, et al. Long-term results after the Rastelli repair for transposition of the great arteries. Ann Thorac Surg 2007; 83: 21692175.Google Scholar
4. Kreutzer, C, De Vive, J, Oppido, G, et al. Twenty-five-year experience with Rastelli repair for transposition of great arteries. J Thorac Cardiovasc Surg 2000; 120: 211223.Google Scholar
5. Dearani, JA, Danielson, GK, Puga, FJ, Mair, DD, Schleck, CD. Late results of the Rastelli operation for transposition of the great arteries. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2001; 4: 315.Google Scholar
6. Lee, JR, Lim, HG, Kim, YJ, et al. Repair of transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction. Eur J Cardiothorac Surg 2004; 25: 735741.CrossRefGoogle ScholarPubMed
7. Hörer, J, Schreiber, C, Dworak, E, et al. Long-term results after the Rastelli repair for transposition of the great arteries. Ann Thorac Surg 2007; 83: 21692175.Google Scholar
8. Lecompte, Y, Neveux, JY, Leca, F, et al. Reconstruction of the pulmonary outflow tract without a prosthetic conduit. J Thorac Cardiovasc Surg 1982; 84: 727733.CrossRefGoogle ScholarPubMed
9. Nikaidoh, H. Aortic translocation and biventricular outflow tract reconstruction: a new surgical repair for transposition of the great arteries associated with ventricular septal defect and pulmonary stenosis. J Thorac Cardiovasc Surg 1984; 88: 365372.Google Scholar
10. Hu, SS, Liu, ZG, Li, SJ, et al. Strategy for biventricular outflow tract reconstruction: Rastelli, REV, or Nikaidoh procedure? J Thorac Cardiovasc Surg 2008; 135: 331338.Google Scholar
11. Yeh, T Jr, Ramaciotti, C, Leonard, SR, Roy, L, Nikaidoh, H. The aortic translocation (Nikaidoh) procedure: midterm results superior to the Rastelli procedure. J Thorac Cardiovasc Surg 2007; 133: 461469.Google Scholar
12. Morell, VO, Jacobs, JP, Quintessenza, JA. Aortic translocation in the management of transposition of the great arteries with ventricular septal defect and pulmonary stenosis: results and follow-up. Ann Thorac Surg 2005; 79: 20892092.Google Scholar
13. Bautista-Hernandez, V, Marx, G, Bacha, E, del Nido, PJ. Aortic root translocation plus arterial switch for transposition of the great arteries with left ventricular outflow tract obstruction: intermediate-term results. J Am Coll Cardiol 2007; 49: 485490.Google Scholar
14. Kramer, P, Ovroutski, S, Hetzer, R, Hübler, M, Berger, F. Modified Nikaidoh procedure for the correction of complex forms of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction: mid-term results. Eur J Cardiothorac Surg 2014; 45: 928934.Google Scholar