NIKAIDOH procedure |
In this operation, the aorta is "switched" ALONG WITH THE AORTIC VALVE and placed in the pulmonary position.
This avoids leak of a faulty pulmonary valve on the left side.
An operation described in the setting of double outlet right ventricle or transposition with pulmonary stenosis,
including pulmonary annular hypoplasia, is aortic translocation with reconstruction of the right ventricular
outflow tract. The aortic root, including the aortic valve, is excised from the right ventricular outflow tract in
a manner analogous to that applied for the pulmonary autograft operation.
In addition, it is necessary to mobilize the coronary arteries, as is done for an arterial switch procedure.
The pulmonary root is divided at the level of the pulmonary valve, which is excised. The outlet septum is
excised, thereby removing the superior margin of the ventricular septal defect. The aortic root is translocated
posteriorly so that it lies primarily over the left ventricle. The ventricular septal defect is closed with a patch,
which is anchored to the aortic root at its superior margin.
The pulmonary artery is connected to the right ventriculotomy with an anterior patch of pericardium.
No large series using this procedure have been reported, so its practicability remains to be determined.
Nevertheless, with increasing experience with the arterial switch and the pulmonary autograft aortic root
operations, the necessary steps w-ill be familiar to surgeons who contemplate using this innovative procedure.
Dr. Hisashi Nikaidoh
E-mail: [email protected]
Mail: 1935 Motor Street
Dallas, TX 75235
Phone: 1 214 640-7280
Fax: 1 214 640-7284