Jatene procedure

Jatene procedure, also known as the arterial switch operation (ASO), is a complex surgical procedure used to correct d-transposition of the great arteries (d-TGA), a congenital heart defect. In d-TGA, the positions of the two main arteries leaving the heart—the pulmonary artery and the aorta—are switched. This condition causes oxygen-poor blood to circulate through the body without passing through the lungs, leading to severe oxygen deficiency in the body. The Jatene procedure is typically performed within the first few weeks of life to correct this life-threatening condition.

Indications[edit | edit source]

The primary indication for the Jatene procedure is d-TGA. In patients with this condition, the survival rate without surgical intervention is extremely low. Early diagnosis and surgical correction are crucial for a positive outcome. The procedure may also be indicated in certain cases of congenitally corrected transposition of the great arteries (ccTGA) when associated with other cardiac anomalies that necessitate surgical intervention.

Procedure[edit | edit source]

The Jatene procedure is performed under general anesthesia with the patient on cardiopulmonary bypass. The operation involves several key steps:

The aorta and pulmonary artery are transected above their respective valves.
The coronary arteries are carefully detached from the native aorta and prepared for reimplantation.
The pulmonary artery and aorta are switched to their correct anatomical positions. The aorta is connected to the left ventricle, and the pulmonary artery is connected to the right ventricle.
The coronary arteries are reimplanted into the neoaorta (the original pulmonary artery now functioning as the aorta).
Any associated defects, such as a ventricular septal defect (VSD), are repaired.

Risks and Complications[edit | edit source]

As with any major cardiac surgery, the Jatene procedure carries risks, including infection, bleeding, and risks associated with cardiopulmonary bypass. Specific complications related to the procedure include:

Coronary artery complications, which can affect heart function
Arrhythmias, or irregular heartbeats
Neoaortic valve regurgitation or dysfunction
Pulmonary artery stenosis at the site of the anastomosis

Outcomes[edit | edit source]

The long-term survival rate after the Jatene procedure has significantly improved over the years, with many patients living well into adulthood. However, lifelong cardiac care is necessary, and some patients may require additional interventions or surgeries later in life.

Follow-up Care[edit | edit source]

Patients who undergo the Jatene procedure require lifelong follow-up with a cardiologist specialized in congenital heart disease. Regular cardiac imaging, such as echocardiography and magnetic resonance imaging (MRI), is essential to monitor heart function, the status of the coronary arteries, and the function of the neoaortic and pulmonary valves.

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