Objective. “Double root translocation (DRT)” procedure is a new surgical technique we proposed in 2004 for the management of patients with ventriculoarterial discordance, VSD, and PS, with intend to preserve the competence and growth potential of the native aortic and pulmonary valve and acquire a better long-term outcomes. This study presents our experiences in 48 consecutive patients.
Methods. Between November 2004 and Dec. 2008, 48 consecutive patients underwent DRT procedure. The patient data is shown in table-1. The operative technique includes that both aortic and pulmonary root were mobilized, excised and translocated. A monovalved pulmonary homograft was used to repair the stenotic pulmonary artery. Coronary arteries re-attachment was needed in 21 patients. Major concomitant procedure included Senning operation in four cases and Glenn operation in one.
Results. The mean cardiopulmonary bypass, aortic cross clamp, and mechanical ventilation time were 322±60min., 219±39min., and 130±142 hours respectively. Six patients required ECMO support and four of them recovered. Two patients died postoperatively. The causes of deaths were left ventricular dysfunction caused by coronary insufficiency. Post-op echocardiography demonstrated that all patients had competent aortic valve and eight had competent pulmonary valve. There is no late death or re-intervention needed during follow-up.
Conclusions. The DRT technique is a feasible and true anatomic repair for patients with anomalies of ventriculoarterial connection, VSD, and PS. Correct coronary artery manipulations are of crucial importance for the success of this procedure. The long-term benefits need to be demonstrated by a larger number of patients and longer follow-up study.