A successful palliative arterial switch operation with arch repair for tricuspid atresia with ventriculoarterial discordance, subaortic stenosis, coarctation, and aortic arch hypoplasia

A successful palliative arterial switch operation with arch repair in a 30-day-old infant with tricuspid atresia, ventriculoarterial discordance, subaortic stenosis, coarctation of the aorta, and aortic arch hypoplasia is reported. A concomitant Blalock-Taussig shunt was required because of insufficient pulmonary blood flow through the restrictive bulboventricular foramen. Postoperative arterial oxygen saturation was maintained around 90% and the pressure gradient between the left ventricle and the pulmonary artery was 45 mmHg according to a Doppler echocardiogram. The infant becomes free of subaortic stenosis and is awaiting the subsequent Fontan operation. This alternative palliative operation for neonates and early infants with double inlet ventricle, subaortic stenosis, and arch hypoplasia offers some advantages on the Fontan operation for avoiding pulmonary arterial distortion and subaortic stenosis followed by ventricular hypertrophy.