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Aortic root translocation: the Bex-Nikaidoh procedure

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Abstract

Patients with transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction are managed by various techniques. Traditional techniques include intracardiac baffling with a right ventricle to pulmonary artery conduit (Rastelli procedure) and the “reparation a l’etage ventriculaire” (REV) procedure. However, other techniques such as aortic root translocation (Bex-Nikaidoh procedure), pulmonary root translocation, and double root translocation are equivalent or in fact provide better results than the traditional techniques. In this review we will have a detailed discussion about aortic root translocation which allows a more normal and anatomically aligned left ventricular outflow tract. However, the operation is technically demanding, and coronary translocation remains one of the major challenges for successful root translocation.

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References

  1. Hörer J, Schreiber C, Dworak E, et al. Long-term results after the Rastelli repair for transposition of the great arteries. Ann Thorac Surg. 2007;83:2169–75.

  2. Rastelli GC, McGoon DC, Wallace RB. Anatomic correction of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis. J Thorac Cardiovasc Surg. 1969;58:545–52.

    Article  CAS  Google Scholar 

  3. Kreutzer C, De Vive J, Oppido G, et al. Twenty-five-year experience with Rastelli repair for transposition of the great arteries. J Thorac Cardiovasc Surg. 2000;120:211–23.

    Article  CAS  Google Scholar 

  4. Dearani JA, Danielson GK, Puga FJ, Mair DD, Schleck CD. Late results of the Rastelli operation for transposition of the great arteries. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2001;4:3–15.

    Article  CAS  Google Scholar 

  5. Bex JP, Lecompte Y, Baillot F, Hazan E. Anatomical correction of transposition of the great arteries. Ann Thorac Surg. 1980;29:86–8.

    Article  CAS  Google Scholar 

  6. Nikaidoh H. Aortic translocation and biventricular outflow tract reconstruction. A new surgical repair for transposition of the great arteries associated with ventricular septal defect and pulmonary stenosis. J Thorac Cardiovasc Surg. 1984;88:365–72.

    Article  CAS  Google Scholar 

  7. Yamagishi M, Shuntoh K, Matsushita T, et al. Half-turned truncal switch operation for complete transposition of the great arteries with ventricular septal defect and pulmonary stenosis. J Thorac Cardiovasc Surg. 2003;125:966–8.

  8. da Silva JP, Baumgratz JF, da Fonseca L. Pulmonary root translocation in transposition of great arteries repair. Ann Thorac Surg. 2000;69:643–5.

    Article  Google Scholar 

  9. da Silva JP, da Fonseca L. Pulmonary root translocation. Oper Tech Thorac Cardiovasc Surg. 2009;14:23–34.

    Article  Google Scholar 

  10. Hu SS, Li SJ, Wang X, et al. Pulmonary and aortic root translocation in the management of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg. 2007;133:1090–2.

  11. Vaidyanathan S, Supreet M, Shilpa M, Nelson A, Vijay A. Options for coronary translocation and other considerations in aortic root translocation (Bex-Nikaidoh procedure). Ann Pediatr Cardiol. 2019;12:228–232.

    Article  Google Scholar 

  12. Raju V, Myers PO, Quinonez LG, et al. Aortic root translocation (Nikaidoh procedure): intermediate follow-up and impact of conduit type. J Thorac Cardiovasc Surg. 2015;149:1349–55.

  13. Morell VO, Jacobs JP, Quintessenza JA. Aortic translocation in the management of transposition of the great arteries with ventricular septal defect and pulmonary stenosis: results and follow-up. Ann Thorac Surg. 2005;79:2089–92.

    Article  Google Scholar 

  14. Yeh T Jr, Ramaciotti C, Leonard SR, Roy L, Nikaidoh H. The aortic translocation (Nikaidoh) procedure: midterm results superior to the Rastelli procedure. J Thorac Cardiovasc Surg. 2007;133:461–9.

    Article  Google Scholar 

  15. Bautista-Hernandez V, Marx GR, Bacha EA, del Nido PJ. Aortic root translocation plus arterial switch for transposition of the great arteries with left ventricular outflow tract obstruction: intermediate-term results. J Am Coll Cardiol. 2007;49:485–90.

    Article  Google Scholar 

  16. Kramer P, Ovroutski S, Hetzer R, Hübler M, Berger F. Modified Nikaidoh procedure for the correction of complex forms of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction: mid-term results. Eur J Cardiothorac Surg. 2014;45:928–34.

    Article  Google Scholar 

  17. Villalba C, Mouratian M, Lafuente M, Dilascio M, Tasat L, Saad A. Biventricular repair in patients with transposition of the great arteries, ventricular septal defect and pulmonary stenosis: Rastelli, Nikaidoh or REV procedures? Argent J Cardiol. 2017;85:241–9.

    Google Scholar 

  18. Honjo O, Kotani Y, Bharucha T, et al. Anatomical factors determining surgical decision-making in patients with transposition of the great arteries with left ventricular outflow tract obstruction. Eur J Cardiothorac Surg. 2013;44:1085–94.

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Correspondence to Vijay Agarwal.

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Agarwal, V., Vaidyanathan, S. Aortic root translocation: the Bex-Nikaidoh procedure. Indian J Thorac Cardiovasc Surg 37 (Suppl 1), 36–41 (2021). https://doi.org/10.1007/s12055-020-00956-7

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