Posted on Authorea 15 Dec 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160805171.18530743/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. hnaoKatahira Shintaro the of arteries transposition great for operation Mustard after Transplantation ru Lichtenberg Artur or-trooydet xetdahsost R.Atrprildseto fteahsos h systemic the adhesions, the of prior dissection partial initiation After (CPB) sRV. bypass to 35 cardiopulmonary adhesions performed expected was and to HTX cannulation due status, femoral re-sternotomy HU included to after strategy days operative Fifty-two B). The A, granted. moreover (Fig.1 was sternum valve, procedure. status the Mustard pulmonary of (HU) after the aspect years urgency to dorsal high relation the and to anatomic l/min*m adhering care close 1.65 grossly in ventricle was relation systemic atrium index atrioventricular anatomic the Cardiac systemic systemic regular of the aorta, at wall in the anterior regurgitation the of baffle moderate for location Mustard and department anterior with the emergency 15% showed 56mm) of the of tomography dimension to computed (EF) (end-diastolic admitted Preoperative fraction dilated was with valve. ejection was years operation sRV impaired 6 second echocardiography, severely and of On birth a age symptoms. after the (HF) months at 15 failure stenosis at heart SVC procedure for Mustard plasty and augmentation d-TGA with man 36-year-old A Report after Case HTX on arteries, reports great narrative the operation. few of Mustard contains position orientation the literature and to Current procedure respect identification HTX. Mustard with Intraoperative during variation anatomic challenges failure. as technical sRV well represent as for chambers, treatment atrial only the regarding procedure the Senning is or Mustard (HTX) e.g., resulting transplantation correction, 1975, of in types introduced earlier was in problem procedure outcomes Jatene improved the (d-TGA), greatly arteries in great the of dextro-transposition In failure late of experiencing case d-TGA Introduction rare with a patient report a We in procedure introduced, follow-up. Mustard was long-term ventricle. after procedure right very years Jatene systemic 36 the before the operation in and arteries of third problem procedures great a Senning the a as or of represents transplantation Mustard dextro-transposition failure heart of with ventricular patients era right In the systemic in increases. progressive treated also initially disease transplantation were heart heart for who corrected presenting (d-TGA) patients congenitally adult of of probability failure the late improve, for diseases heart congenital of outcomes long-term As Abstract 2020 15, December 3 2 1 nvriyHsia Dusseldorf Hospital University University Tohoku Dusseldorf Heinrich-Heine-Universitat 3,4 1 3 uiauSugimura Yukiharu , afWestenfeld Ralf , ee edmntaeacs ln ihasria ie fscesu T after HTX successful of video surgical a with along case a demonstrate we Here, . 1 oee,ssei ih etiua sV alr nautodbcmsa becomes adulthood in failure (sRV) ventricular right systemic However, . 2 n nta att a . mll h ain a ditdt intensive to admitted was patient The mmol/l. 1.6 was lactate initial and 1 d Boeken Udo , 1 u Aubin Hug , 1 1 n aa Akhyari Payam and , 1 aaoIse Hayato , 2 ntelte ain oot heart cohort, patient latter the In . 1 ohktuSaiki Yoshikatsu , 1 2 , Posted on Authorea 15 Dec 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160805171.18530743/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. aasaigi o plcbet hsatcea onwdt eecetdo nlzdi hsstudy. this in analyzed or created were data new no as article this to applicable not is sharing The Data Istanbul. manuscript. of this Declaration of statement: the publication availability and the Data Helsinki for of obtained Declaration was the consent of reconstruction informed principles appropriate special the no followed side, manuscript removed the right This be the Since possible. can on was heart method located anastomosis. the bicaval were approval: and atrial normal was SVC Ethical pericardium, the atrium left and and with right IVC the atrium reconstruction the case, the and of clamped, this from required, was creation In was PV aorta the and injury. ascending atrium was without severe, left case was safely the PV this confirm and to of atrium incised surgery right HTX, the enable the between to in adhesion scenarios devised anatomic experienced complex point not im- grafts for The vascular to Although necessary or obtained be strategy. baffle be may operative (e.g., a should steps using regarding structures baffle) reconstruction e.g., finding atrial further native (e.g., decision case, of thorough material this preoperative localization implant in A of reconstructive precise quality and for operations. the PVs) prove previous modalities of ostia after imaging Anatom- and particularly modern course ventricle. challenge, utilizing systemic considerable failing workup with a diagnostic patients represent d-TGA abnormalities of represent treatment issues ical successful technical favor intraoperative for to management, components suggest postoperative important cohort may and patient which sRV, stabilization particular has in pre-operative therapy this VAD Beyond (VAD) of in device results choice mixed assist first ventricular with the however, Implantable as scenario, surgery. latter HTX after procedure the late Jatene in resulting reported before sRV been performed the was of procedure failure Mustard sive d-TGA, of case the In problem 33 particular the no on Discussion was discharged There catecholamines, was 1 of on unremarkable. he doses complications. extubated was minutes. and other was moderate course echocardiography, 214 patient with was postoperative postoperative The performed time further with therapy. was ischemia and prostacyclin CPB heart inhalative day intermittent donor from postoperative Total and mismatch weaning oxide, size reperfusion, remarkable material. nitric a of the inhalative prosthetic by without min without arteries complicated graft 131 feasible great further donor of was After the be anastomoses anastomosis of to both aortic segments proved perform The was longer but to aorta Utilizing materials. possible ascending prosthetic anatomy. was distal of it normal the by use lines, the arteries, anastomotic performed artery, was to great distal was pulmonary left graft recipient more SVC, HTX slightly cardiac IVC, of and arch. and atrium, excision side, aortic anteriorly left liberal donor of the located more order the of yet the the part enlarge on Despite in to most modification performed order aorta. including was further in ascending aorta, anastomosis ostia a the the PV and As atrial of method right segment two bicaval and side. the long left recipient between a the in the between with performed in harvested on was cranially line cuff and the atrial caudally anastomotic from left as distant the well patients. remaining possible relatively as HF the as ostia in much be of anatomy PV as incision to common left performed perpendicular the revealed was to Addition line distance compared incision ostia. inter-PV when the remarkably PV size the heart, was in recipient correction, aorta limited excising cuff Mustard the when from atrial of Therefore, of left location dimension technique anatomic PV HTX recipient the specific regular and resulting as in the small well The than to baffle bicaval as distally relation. Due more Mustard side later anatomic transected and endocardial were regular small. for trunk the more opened pulmonary incised a from was and achieve were identified Aorta atrium to were veins (Fig.2). right) Aortic ostia atrium caval anatomic the (PV) both of (i.e., vein manipulation. outside and pulmonary systemic and as embolism, Next, well preparation air as heart. further avoid donor during to of congestion early implantation pulmonary performed avoid was to clamping vented was atrium 3 . 2 5 . rd otprtv a ihu any without day postoperative 2 rvdn ihprogres- with providing , st Posted on Authorea 15 Dec 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160805171.18530743/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. dnie n AadP ol ecnre nenahi h et ftessei tilchamber. atrial upper systemic right RUPV, the vein; of pulmonary depth lower left the vein LLPV, in pulmonary vein; underneath lower pulmonary right confirmed immediately upper RLPV, became be vein; left baffle pulmonary LUPV, could Mustard atrium; the PV left incised, and was LA, atrium, LA systemic and i.e., atrium, identified right anatomic the ventricle. When right RV; artery; cava; are pulmonary vena aorta PA, superior 2. and trunc. RV SVC, towards Fig. pulmonary cava; systemic baffle the vena the the and that inferior ventricle through shows IVC, pulmonary view ventricle; re-directed the Sagittal left are to LV, (B) IVC PA. respect and with with connected SVC anteriorly LV of located the flow and valve blood mitral that the demonstrates view Frontal (A) long-term 1. with transplantation Fig. to Bridge O. Legends Szarszoi Figure procedure. J, Mustard Pirk the Z, after Dorazilova adults J, 1181. in Besik device I, assist Netuka mechanical J, D-transposition with procedure. Maly patient a Mustard in 5. a transplantation heart after Orthotopic arteries: al. great et T, the situs Chu with of ID, patient Gregoric a GN, in Messner operation. transplantation Mustard 4. heart and Orthotopic arteries JM. After great Padro the Survival J, of Long-Term Montiel transposition A, ME. invs, Ginel Oster C, Munoz-Guijosa JD, Louis 3. Arteries. St Great L, the vessels. of Kochilas d-Transposition great C, in 1833. the McCracken Switch of M, Atrial transposition Versus Kelleman of Arterial A, correction Kiener Anatomic 2. al. et PP, Paulista Surg. VF, Cardiovasc Fontes Thorac AD, Jatene 1. References nroeaieimaging Intraoperative tomography computed enhanced Preoperative 1976;72(3):364-370. e er ntJ. Inst Heart Tex 3 u adohrcSurg. Cardiothorac J Eur er ugTransplant. Lung Heart J 2005;32(4):541-543. n hrcSurg. Thorac Ann 2008;34(1):219-221. 2018;106(6):1827- 2015;34(9):1177- J Posted on Authorea 15 Dec 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160805171.18530743/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 4