[Arterial switch operation in reconstructive surgery]

Arterial switch is a relatively novel surgical approach aimed at augmentation of blood flow at the account of less important arterial branches. The method consists in suturing vessels of different diameter end to end and end to side. Arterial switch is used for perfusion of donor organs, kidney in particular. The authors suggested a variant of arterial switch--intrapericardial subclavian to pulmonary arterial anastomosis--in the presence of stenosis of right ventricular outflow tract in tetralogy of Fallot. This anastomosis has several advantages over classical methods of surgical correction of Fallot's tetralogy. Coronary artery bypass surgery using mammary artery grafts is based on arterial switch principle and represents the most effective technique of treatment of coronary artery stenoses. Multiple experimental and clinical methods of arterial switch having been proposed and investigated by the authors since 1955 have found wide application in reconstructive surgery.