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  • Title: Double switch operation in cardiac anomalies with atrioventricular and ventriculoarterial discordance.
    Author: Yagihara T, Kishimoto H, Isobe F, Yamamoto F, Nishigaki K, Matsuki O, Uemura H, Kamiya T, Kawashima Y.
    Journal: J Thorac Cardiovasc Surg; 1994 Feb; 107(2):351-8. PubMed ID: 8302053.
    Abstract:
    Since June 1987, 10 of 19 consecutive patients with atrioventricular and ventriculoarterial discordance (average age 4 +/- 2 years) had undergone a double switch operation with the morphologically left ventricle used as a systemic ventricle. There were two combinations of procedures. Atrial switch combined with arterial switch was used in two patients who had a normal pulmonary valve. Atrial switch combined with ventriculoarterial switch by Rastelli's procedure was used in eight patients with pulmonary stenosis or atresia and a large ventricular septal defect. One early death and two late deaths have occurred in a postoperative follow-up period of up to 4 years. Subsequent problems were mainly related to the results of atrial switch procedures in patients who had a small atrium because of low pulmonary flow, especially in patients with apicocaval juxtaposition. Our experience suggested that the double switch operation would open a new era of definitive surgical treatment in half of the patients with atrioventricular and ventriculoarterial discordance.
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