[An anterior longitudinal aortotomy with a distal aortic transection for the arterial switch operation]

There are several methods of aortic transection of the ascending aorta and removal of coronary buttons in the arterial switch operation for the transposition of the great arteries. After transecting the aorta as far distally as possible, we place an additional aortotomy which runs longitudinally on the anterior aspect of the ascending aorta. This incision facilitates removal of the coronary buttons in a good operative field, avoids distortion of the Valsalva's sinuses and makes reconstruction of the neopulmonary artery easier after Lecompte maneuver with a anterior patch finally if needed, especially in the neonatal arterial switch operation. Consecutive 4 patients ¿the 1st is neonatal TGA I with single coronary artery (Shaher 3a), the 2nd is neonatal TGA II, the 3rd is neonatal TGA I with singal coronary artery (Shaher 3c), 4th is infantile (48 days) TGA II with single coronary artery (Shaher 3c)¿ have been operated upon this technique with good results recently.