This is a technically challenging procedure, but results in a more "normal" anatomic repair. The main thing is the repositioning of the native aortic root over to the LV cavity, avoiding the creation of a long tortuous intraventricular tunnel. This technique appears to prevent the development of LVOTO, which is a frequent complication of the Rastelli repair. The addition of the Lecompte maneuver may prevent branch pulmonary artery stenosis that may occur secondary to compression of the PA by the posteriorly displaced, translocated aortic root. It creates a direct RV to PA anastomosis and avoiding the use of a conduit, which should decrease the incidence of RVOT reinterventions. Lecompte
Since 1981 LeCompte has put his LeCompte manoeuvre in use. This is used with the REV (Réparation à lEtage Ventriculaire). This surgery is like the Rastelli procedure, but with the use of the pulmonary artery without a conduit. Rastelli
When an arterials switch operation (ASO) is not possible e.g. in case of LVOTO an option is the Rastelli procedure. The pulmonal artery is shifted with help of conduit to the right ventricle. It has been used since 1960s. It has a disadvantage that the conduit does not grow, so re-operation is necessary. Arterial switch
The Jatene procedure surgery is the preferred, and most frequently used, method of correcting d-TGA. It is ideally performed on an infant between 8–14 days old.
Paediatric units normally provide facilities and equipment for mothers of infant patients to pump their breastmilk, which can then be fed to the infant through the NG tube, and/or stored for later use. Oxygen therapy is commonplace for hospitalized d-TGA patients. This may range from an oxygen mask resting on the bed nearby their head to intubation. In some cases, patients are intubated as a precaution; the machine can monitor breathing and supplement the patient as much or as little as they need. IVs are used to deliver medication, blood products, or other fluids to the patient. Arterial lines provide a constant monitor of blood pressure, as well as a method of obtaining samples for blood gas tests; central lines can also monitor blood pressure and provide blood samples, as well as provide a means to deliver medication and nourishment; fingerpricks (or heelpricks on small babies) are used to obtain blood samples for certain tests. A sphygmomanometer may be used for intermittent blood pressure monitoring even if a patient is being otherwise monitored using a central or arterial line. A pulse oximeter is attached to a finger or toe and provides constant or intermittent monitoring of the bloods oxygen saturation level.An EKG creates a visual readout of how well the heart rhythm is functioning. Medication
Prostaglandin (PGE)
Antibiotics
Diuretics
Analgesics
Cardiac glycosides
Sedatives
When PGE is administered to a newborn, it prevents the ductus arteriosus from closing, therefore providing an additional shunt through which to provide the systemic circulation with a higher level of oxygen.Antibiotics may be administered preventatively.