The Nikaidoh Operation: An Aortic Translocation Repair
The patient is a two-and-a-half-year-old child with d-TGA/VSD/PS who underwent aortic translocation. The patient’s anatomy was typical of d-transposition with VSD and PS. Both coronaries were favorable in that they were off of the epicardium.
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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.