Interposition of a modified aortic homograft conduit as main pulmonary trunk in anatomic correction of transposition of the great arteries. Report of two cases and technical considerations.

Anatomic correction of transposition of the great arteries and ventricular septal defect has been performed successfully in two patients. The technique employed differed in several aspects from the so-called Jatene procedure: (1) Both great arteries were transected at low level; (2) the switch of the coronary arteries was carried out after transection of both great arteries; (3) a modified aortic homograft conduit was used to bridge the gap between the proximal aortic root and the distal main pulmonary artery; (4) the "new" main pulmonary arterial trunk was positioned on the right side of the ascending aorta; and (5) the ascending aorta was enlarged in order to match the dilated proximal pulmonary stump. The advantages of these modifications over other techniques reported in the literature are discussed.