@Article{chd.12749,
AUTHOR = {Mehmet Salih Bilal, Arda Özyüksel, Mustafa Kemal Avşar, Şener Demiroluk, Osman Küçükosmanoğlu, Yalım Yalçın},
TITLE = {A better approach for left ventricular training in transposition of the great arteries and intact interventricular septum: Bidirectional cavopulmonary anastomosis and pulmonary artery banding},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {3},
PAGES = {464--469},
URL = {http://www.techscience.com/schd/v14n3/38794},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Management of the patients with transposition of the great arteries and 
intact ventricular septum may be challenging beyond the newborn period. Herein, we 
would like to present our alternative strategy for training the left ventricle in these 
patients.<br/>
<b>Methods:</b> Six patients with transposition of the great arteries and intact ventricular 
septum were evaluated in our clinic. Two of them were palliated with Glenn procedure and pulmonary banding as a definitive treatment strategy at other centers. Four 
patients were operated on and a bidirectional cavopulmonary anastomosis in combination with pulmonary artery banding was performed (stage‐1: palliation and ventricular training) in our center. In four out of these six patients, arterial switch 
operation was performed with takedown and direct re‐anastomosis of the superior 
vena cava to right atrium after an interstage period of 21‐30 months (stage‐2: anatomical repair).<br/>
<b>Results:</b> Any mortality was not encountered. The left ventricular mass indices increased from 18‐32 to 44‐74 g/m2
 in patients undergoing the anatomical repair. All 
of the patients were uneventfully discharged following the second stage. The mean 
follow‐up period was 20 months (9‐32 months) following stage 2. All of the patients 
are doing well with trivial neoaortic regurgitation and normal biventricular function.<br/>
<b>Conclusions:</b> Bidirectional cavopulmonary anastomosis with pulmonary artery banding may be a promising left ventricle training approach in ventriculoarterial discordance when compared to the traditional pulmonary artery banding with concomitant 
systemic‐to‐pulmonary artery shunt procedures which still carry a significant interstage morbidity and mortality.},
DOI = {10.1111/chd.12749}
}