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[Two-stage Jatene procedure after Mustard or Senning operation]
1Department of Pediatric Cardiovascular Surgery, Tokyo Women's Medical College, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|September 1, 1992
Summary
The two-stage Jatene procedure effectively treats severe right ventricular dysfunction after atrial switch operations for transposition of the great arteries. Pulmonary artery banding prepares the left ventricle, leading to improved cardiac function and recovery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Context:
- Atrial switch operations (Mustard/Senning) for transposition of the great arteries can lead to severe right ventricular dysfunction.
- Re-intervention is often necessary to address persistent hemodynamic issues.
Purpose:
- To evaluate the efficacy of a two-stage Jatene procedure in patients with right ventricular dysfunction post-atrial switch.
- To assess the role of pulmonary artery banding in preparing the left ventricle for arterial switch.
Summary:
- Four patients with severe right ventricular dysfunction post-atrial switch underwent a two-stage Jatene procedure.
- Pulmonary artery banding successfully prepared the left ventricle, evidenced by increased wall thickness despite a temporary decrease in ejection fraction.
- Post-Jatene procedure, left ventricular ejection fraction recovered, right ventricular volume normalized, cardiac index improved, and sinus node function was restored.
Impact:
- The Jatene procedure is a viable alternative for managing right ventricular dysfunction after atrial switch operations.
- Pulmonary artery banding is an effective preparatory step for the arterial switch in these complex cases.
- Restoration of biventricular physiology improves long-term outcomes in complex congenital heart disease.