Transposition of the Great Arteries and Quadricuspid Pulmonary Valve: An Unusual Combination Marco Ricci, MD, Gordon A. Cohen, MD, PhD, Ergin Kocyildirim,

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Presentation transcript:

Transposition of the Great Arteries and Quadricuspid Pulmonary Valve: An Unusual Combination Marco Ricci, MD, Gordon A. Cohen, MD, PhD, Ergin Kocyildirim, MD, Sachin Khambadkone, MD, Martin J. Elliott, MD The Annals of Thoracic Surgery Volume 79, Issue 4, Pages 1428-1430 (April 2005) DOI: 10.1016/j.athoracsur.2003.12.042

Fig 1 Two-dimensional transthoracic echocardiography showing the aorta and the pulmonary trunk in an anterior-posterior relationship. The posterior semilunar valve (pulmonary valve) appears to be quadricuspid. The Annals of Thoracic Surgery 2005 79, 1428-1430DOI: (10.1016/j.athoracsur.2003.12.042)

Fig 2 Arterial switch operation in transposition of the great arteries and quadricuspid pulmonary valve. (A) Arrangement of the great arteries, semilunar valves, and coronary arteries. The anterior aortic valve is tricuspid and the coronary pattern is the normal one. The posterior pulmonary valve is quadricuspid. (B) A button of neo-aortic wall is excised from the facing sinus between the two anterior commissural posts at and below the sino-tubular junction. (C) The two coronary buttons are implanted on the neo-aorta side-by-side using a continuous 7-0 polypropylene suture. (D) A second 7-0 running suture is used to join the two buttons. (E) Reimplantation of the coronary buttons has been completed. Note that a neo-sinus is created by partially approximating the upper edge of the two coronary buttons. The Annals of Thoracic Surgery 2005 79, 1428-1430DOI: (10.1016/j.athoracsur.2003.12.042)