Arterial switch operation: Difference between revisions
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''' | == Arterial Switch Operation == | ||
[[File:Blausen_0046_ArterialSwitchOperation_01.png|Arterial Switch Operation - Step 1|thumb|right]] | |||
The '''arterial switch operation''' is a surgical procedure used to correct [[transposition of the great arteries]] (TGA), a congenital heart defect where the [[aorta]] and the [[pulmonary artery]] are switched from their normal positions. This operation is typically performed in the first few weeks of life and is considered the standard treatment for TGA. | |||
== History == | == History == | ||
The arterial switch operation was first | The arterial switch operation was first successfully performed by Dr. [[Adib Jatene]] in 1975. Prior to this, the [[Mustard procedure]] and the [[Senning procedure]] were the primary surgical treatments for TGA, but these were palliative rather than corrective. | ||
== Indications == | |||
The primary indication for the arterial switch operation is [[dextro-transposition of the great arteries]] (d-TGA), where the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. This anatomical arrangement results in two parallel circulations, which is incompatible with life unless there is mixing of oxygenated and deoxygenated blood. | |||
== Surgical Technique == | |||
The arterial switch operation involves several key steps: | |||
=== Step 1: Mobilization of the Great Arteries === | |||
[[File:Blausen_0047_ArterialSwitchOperation_02.png|Arterial Switch Operation - Step 2|thumb|left]] | |||
The first step involves mobilizing the aorta and pulmonary artery. The [[coronary arteries]] are also carefully dissected from the aorta to be reimplanted later. | |||
=== Step 2: Transection and Reanastomosis === | |||
The aorta and pulmonary artery are transected, and their positions are switched. The aorta is connected to the left ventricle, and the pulmonary artery is connected to the right ventricle. The coronary arteries are then reimplanted into the new aorta. | |||
=== Postoperative Care === | |||
[[File:Postop_Jatene_neonate.jpg|Postoperative Jatene procedure in a neonate|thumb|right]] | |||
After the operation, the patient is monitored in the [[intensive care unit]] (ICU). Postoperative care includes managing [[hemodynamics]], preventing [[infection]], and ensuring adequate [[oxygenation]]. | |||
== | == Complications == | ||
Potential complications of the arterial switch operation include: | |||
* Coronary artery insufficiency | |||
* [[Pulmonary artery stenosis]] | |||
* [[Aortic regurgitation]] | |||
* [[Arrhythmias]] | |||
== Outcomes == | == Outcomes == | ||
The arterial switch operation has a high | The arterial switch operation has excellent outcomes with a high survival rate. Most patients lead normal lives with regular follow-up care to monitor heart function. | ||
== | == Related Pages == | ||
* [[Congenital heart defect]] | * [[Congenital heart defect]] | ||
* [[Cardiac surgery]] | |||
* [[Transposition of the great arteries]] | * [[Transposition of the great arteries]] | ||
[[Category:Cardiac surgery]] | [[Category:Cardiac surgery]] | ||
[[Category: | [[Category:Congenital heart disease]] | ||
Latest revision as of 11:22, 23 March 2025
Arterial Switch Operation[edit]
The arterial switch operation is a surgical procedure used to correct transposition of the great arteries (TGA), a congenital heart defect where the aorta and the pulmonary artery are switched from their normal positions. This operation is typically performed in the first few weeks of life and is considered the standard treatment for TGA.
History[edit]
The arterial switch operation was first successfully performed by Dr. Adib Jatene in 1975. Prior to this, the Mustard procedure and the Senning procedure were the primary surgical treatments for TGA, but these were palliative rather than corrective.
Indications[edit]
The primary indication for the arterial switch operation is dextro-transposition of the great arteries (d-TGA), where the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. This anatomical arrangement results in two parallel circulations, which is incompatible with life unless there is mixing of oxygenated and deoxygenated blood.
Surgical Technique[edit]
The arterial switch operation involves several key steps:
Step 1: Mobilization of the Great Arteries[edit]
The first step involves mobilizing the aorta and pulmonary artery. The coronary arteries are also carefully dissected from the aorta to be reimplanted later.
Step 2: Transection and Reanastomosis[edit]
The aorta and pulmonary artery are transected, and their positions are switched. The aorta is connected to the left ventricle, and the pulmonary artery is connected to the right ventricle. The coronary arteries are then reimplanted into the new aorta.
Postoperative Care[edit]
After the operation, the patient is monitored in the intensive care unit (ICU). Postoperative care includes managing hemodynamics, preventing infection, and ensuring adequate oxygenation.
Complications[edit]
Potential complications of the arterial switch operation include:
- Coronary artery insufficiency
- Pulmonary artery stenosis
- Aortic regurgitation
- Arrhythmias
Outcomes[edit]
The arterial switch operation has excellent outcomes with a high survival rate. Most patients lead normal lives with regular follow-up care to monitor heart function.
