Arterial switch operation with autologous sinus tube for transposition of great vessels with single coronary.

This video tutorial demonstrates an arterial switch operation utilizing an autologous coronary sinus tube in a 6-day-old female born with dextro-transposition of the great arteries, ventricular and atrial septal defects, and complex coronary anatomy, with a single coronary artery origin from left-facing running anterior to the aortic root. A standard button transfer was deliberately avoided to minimize the risk of distortion of the coronary arteries. Thus, native aortic sinus tissue was harvested as a contiguous flap and fashioned into a tubular conduit. The constructed tube was implanted into the neoaortic tube through a trapdoor incision. The autologous coronary tube was constructed to be a tension-free conduit while ensuring that coronary orientation and patency were preserved. A small residual atrial septal defect was left intentionally to facilitate post-operative haemodynamic adaptation. The patient was discharged on post-operative Day 10 with normal left ventricular function, stable mild aortic and pulmonary valve regurgitation, and laminar antegrade flow in the reimplanted proximal single coronary button.