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The Nikaidoh procedure for complex transposition of the great arteries: short-term follow-up

Published online by Cambridge University Press:  14 November 2016

Guillermo Ventosa-Fernández ,
Carolina Pérez-Negueruela ,
Javier Mayol ,
Marina Paradela  and
José M. Caffarena-Calvar
Guillermo Ventosa-Fernández*
Affiliation:
Cardiovascular Surgery Department, Clinic Hospital of Barcelona, Universidad de Barcelona, Barcelona, Spain
Carolina Pérez-Negueruela
Affiliation:
Cardiovascular Surgery Department, San Joan de Deu Hospital, Barcelona, Spain
Javier Mayol
Affiliation:
Cardiovascular Surgery Department, San Joan de Deu Hospital, Barcelona, Spain
Marina Paradela
Affiliation:
Thoracic Surgery Department, Clinic Hospital of Barcelona, Barcelona University, Barcelona, Spain
José M. Caffarena-Calvar
Affiliation:
Cardiovascular Surgery Department, San Joan de Deu Hospital, Barcelona, Spain
*
Correspondence to: G. Ventosa-Fernández, Cirugia Cardiovascular, Hospital Clinic Barcelona, Villarroel 170, 08036 Barcelona, Spain. Tel: +34 65 260 76 44; Fax: +34 92 227 57 49; E-mail: guillermo_ventosa@hotmail.com
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Abstract

Background

The surgical treatment for complex forms of d-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction remains controversial. In this study, we describe the classical surgical options – namely, the Rastelli procedure and the “réparation à l’étage ventriculaire” – and present our experience with the modified Nikaidoh procedure with early and short-term follow-up results.

Methods

Between 2007 and 2014, four patients with d-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction underwent surgical repair at our institution by means of a modified Nikaidoh procedure.

Results

With a mean follow-up of 4.5 years, survival was 100%, and none of the patients required re-intervention or mechanical circulatory support. There was no recurrence of left ventricular outflow tract obstruction and no aortic valve regurgitation classified as more than mild. Left ventricular function was preserved.

Conclusions

Aortic translocation with the modified Nikaidoh procedure is a safe and effective surgical treatment for certain complex forms of transposition of the great arteries, particularly those associated with ventricular septal defect and left ventricular outflow tract obstruction. It is associated with less need for re-intervention and better morbidity and mortality results in the short- and mid-term follow-up, when compared with the classical alternatives such as the Rastelli procedure.

Keywords

CHDtransposition of great vesselsNikaidoh interventionleft ventricular outflow tract obstructionaortic root
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 945 - 950
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Copyright
© Cambridge University Press 2016 

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