Primary Arterial Switch Operation for TGA/IVS and Regressed Left Ventricle: How and When to Use Left Ventricular Assist Device

World J Pediatr Congenit Heart Surg. 2020 Jan;11(1):97-100. doi: 10.1177/2150135119879876.


Purpose: Numerous attempts have been made to extend the boundaries of arterial switch operation (ASO) in children presenting late with transposition of great arteries with intact ventricular septum (TGA/IVS) and regressed left ventricle (rLV). Many children tolerate the delayed ASO uneventfully, whereas others need mechanical circulatory support (MCS) to sustain the systemic circulation while the left ventricle undergoes retraining.

Description: In this article, we describe six consecutive children with TGA/IVS and rLV who underwent primary ASO.

Results: Three were managed medically, while three required MCS in the form of Centrimag left ventricular assist device (LVAD). All patients survived the operation and were discharged home in a stable condition.

Conclusions: Primary ASO can be safely performed in children with TGA/IVS and rLV, provided the center has MCS options. Supporting the rLV with LVAD is feasible and can be achieved safely.

Keywords: arterial switch operation; circulatory assist devices (LVAD, RVAD, BVAD, TAH); congenital heart surgery; left; ventricle.

Publication types

  • Case Reports

MeSH terms

  • Arterial Switch Operation
  • Echocardiography
  • Female
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / pathology
  • Heart Ventricles / surgery*
  • Heart-Assist Devices
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Transposition of Great Vessels / diagnostic imaging
  • Transposition of Great Vessels / surgery*
  • Treatment Outcome