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Bayard Gontijo
Public Documents
1
IS SLIM BETTER THAN PAUNCHY?
Bayard Gontijo
and 1 more
June 30, 2021
Aorto-Pulmonary Mismatch (APM) in Transposition of the Great Arteries (TGA) may be accountable for dilatation of neoaortic root and regurgitation of neoaortic valve as late complications of ASO. The manuscript from Arcieri et al. highlights an important aspect about ASO technique: should we approach APM during ASO and what would be the best strategy to do so? Techniques to approach APM at the time of ASO have been published sporadically and are very rarely employed by surgeons. Reconstruction of the neoaorta is generally achieved by trimming of the suture line between pulmonary root (neoaortic root) and ascending aorta resulting in an abnormal dilated and bulky neoaortic root already at the time of ASO. Reduction of the pulmonary root dimension by ressection of a fragment of the pulmonary artery wall possibly results in a more homogenous neoaorta with consequent better hemodynamics. We believe that approaching APM during ASO will have a compelling positive impact in the late survival of the patients with complex TGA.