Objective To summarize clinical experience of a single stage surgical approach on patients with TaussigBing anomaly combined with side by side relationship of great arteries. Methods From May 2000 to Sep. 2007, 26 patients (age 3.1±2.2 months) with TaussigBing anomaly with side by side great arteries underwent the single stage operation, including arterial switch operation (n=25), and Kawashima operation (n=1). Aortic arch obstruction was present in 13 patients. The corrections of aortic arch obstruction included descending aorta end to end anastomosis to aortic arch or end to side anastomosis to ascending aorta. Results The hospital mortality rate was 11.5% (3/26). There was no operative death in continuous 15 patients after Jun. 2005. 21 patients were followed up for 1 to 5 years. The patients’ growth and development were improved obviously. The sizes of the hearts were smaller than those before operations. The pulmonary blood flow was decreased obviously. Two patients required re-operations because of supravalvular pulmonary stenosis. Conclusion Taussig-Bing anomaly with side by side great arteries has complex anatomical characters. In order to improve the operative outcomes, the optimized operative strategies should be considered in according with different anatomies.
Objective To evaluate the efficacy of 3-dimensional printing model (3DPM) aiding decision making and surgery rehearsal for the treatment of double outlet right ventricle (DORV) with non-committed ventricular septal defect (NC-VSD). Methods From January 1st, 2012 through December 30th, 2014, 12 patients with DORV and NC-VSD were operated with the aid of “3DPM guidance” to do decision making and surgical technique rehearsal preoperatively. There were 9 males and 3 females at age of 2.9±2.2 years. The “3DPM guidance” consisted of step by step procedures: computerized tomography (CT) scan for the patients, CT based 3DPM rendering, 3DPM exploration, decision making, and surgery rehearsal. During surgery rehearsal, surgeons did patch designing, VSD enlargement planning, muscle bundle resection etc. Eight out of the twelve patients underwent biventricular repair, 4 patients underwent single ventricle repair. Six of the eight biventricular repair patients had intra-ventricular baffle repair, 1 patient had intra-ventricular baffle repair and arterial switch procedure, 1 had modified Nikaidoh procedure. VSD enlargement was performed in all the patients in biventricular repair group. The reasons not to do a biventricular repair included very restrictive VSD, tricuspid attachments across the sub-aortic passway. Results The operation findings correlated well with the 3DPM in all the cases. There was no hospital death, no major complication. One patient had a mild sub-aortic stenosis and he was under close follow-up. There was no late death and reoperation. Surgeons involved were satisfied with the “3DPM guidance”. Conclusions 3-D printing model is an excellent way to help decision making for DORV with NC-VSD and can provide surgery simulation which decrease complication rate and help achieve good outcomes.