Clinical Procedure
 
Aliases:
Jatene procedure
ASO
Aterial switch operation

Topic aliases are alternate phrasings for a particular topic.


Procedure performed to correct d TGA, whereby the great arteries are excised and reimplanted to the correct corresponding ventricles and re-establish a circulation in series.

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A direct left atrial line and right atrial line will frequently be placed by the surgeon for postoperative monitoring.

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Arrhythmias in the postoperative period may indicate coronary ischemia.

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Consider GTN infusion on pump and off pump to minimise coronary artery vasospasm.

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Pay close attention to and maintain relatively low left atrial filling pressures coming off bypass (~6mmHg) by being cautious with filling.
Distension of the left atrium may alter anatomy to the extent that the newly implanted coronary arteries may become impinged or possibly even avulsed.
A high LAP may also suggest diastolic failure that may be a consequence of reduced coronary artery flow/myocardial perfusion through the newly implanted coronaries.

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