1. Arterial Switch Operation: Operative Approach and Outcomes
Tyson A. Fricke, MBBS, BMedSci, Igor E. Konstantinov, MD, PhD 
The Annals of Thoracic Surgery 
Volume 107, Issue 1, Pages (January 2019)
DOI: /j.athoracsur
Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
Trapdoor technique for arterial switch operation. (A) Following identification of coronary anatomy, (B) medially based trapdoors are made in the native pulmonary (neoaortic) root. To avoid further enlargement of the neoaortic root, (B1) the coronary buttons are trimmed and (C) coronary transfer is completed in standard fashion. (Ao = aorta; LAD = left anterior descending; LCX = left circumflex artery; PA = pulmonary artery; RCA = right coronary artery.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
Single coronary artery transfer from nonfacing sinus. (A) The single coronary artery from the nonfacing sinus is translocated to (B) the neoaortic root faciliated by an interposition graft. (Ao = aorta; PA = pulmonary artery.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

4. Fig 3
Transfer of intramural coronary. (A) Following identification of the intramural segment (1 = sinus 1; 2 = sinus 2), (B) the detachment of the posterior commissure of the aortic (neopulmonary) valve was performed in most patients (n = 25). (C) The unroofing of the intramural coronary artery was done in 16 patients. (D) Then the coronary arteries were detached and transferred either as a single button facilitated with a pericardial hood (D1–D3) in the first 3 patients or (E) as 2 separate buttons using the trapdoor technique (E1–E2) in the next 25 consecutive patients. In all patients the pulmonary artery was reconstructed with a single autologous pericardial patch and the posterior neopulmonary commissure was re-attached to it. (Reproduced from [44] with permission from The Society of Thoracic Surgeons.) (LAD = left anterior descending artery; LCx = left circumflex artery; RCA = right coronary artery.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

5. Fig 4
Repair of aortic arch obstruction and arterial switch operation. (A) Interrupted aortic arch with transposition of the great arteries and associated subneopulmonary obstruction. (B) Lecompte maneuver with end-to-side anastomosis of descending aorta (Ao) to ascending Ao, and resection of subneopulmonary obstruction is performed to reconstruct the aortic arch and prevent subpulmonary stenosis. (LV = left ventricle; PA = pulmonary artery; PDA = patent ductus arteriosus; RV = right ventricle; VSD = ventricular septal defect.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

6. Fig 5
Arterial switch operation in Taussig-Bing anomaly. (A) Patients with Taussig-Bing anatomy often have size discrepancy between aorta (Ao) and pulmonary artery (PA) and may develop right ventricular outflow tract (RVOT) obstruction due to subaortic conus. (B) Due to side-by-side arrangement of the Ao and PA, a newly reconstructed main PA is reimplanted into the right PA. (C) Conal septum is resected before ventricular septal defect (VSD) closure to avoid RVOT obstruction.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions