Hemi-Nikaidoh: Partial Aortic Root Translocation and Posterior Left Ventricular Outflow Tract Plasty

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease Repair

Background:

• The Nikaidoh operation is an anatomic repair for ventriculoarterial discordance, ventricular septal defect, and pulmonary stenosis.
• Limitations exist with diminutive pulmonary annuli or hypoplastic left ventricular outflow tracts, where posterior aortic translocation is minimal.

Purpose of the Study:

• To introduce the "hemi-Nikaidoh" procedure as an alternative surgical approach.
• To describe a novel technique for achieving geometric shift in specific congenital heart defects.

Main Methods:

• Mobilizing the anterior two-thirds of the aortic root.
• Performing posterior aortic translocation by plicating the left ventricular outflow tract without conus division.
• Reconstructing the right ventricular outflow tract with an orthotopic conduit.

Main Results:

• The hemi-Nikaidoh procedure achieves geometric shift by altering aortic root and left ventricular outflow tract geometry.
• This technique provides an alternative when the standard Nikaidoh operation's benefits are limited.

Conclusions:

• The hemi-Nikaidoh operation is a viable alternative for complex congenital heart disease repairs.
• This modification addresses specific anatomical challenges, enhancing surgical options for ventriculoarterial discordance.