Restrictive Left Ventricle-to-Pulmonary Artery Conduit as an Alternative Biventricular Strategy in Complex ccTGA

In patients with congenitally corrected transposition of the great arteries (ccTGA), a nonrestrictive ventricular septal defect (VSD), and left ventricular outflow tract obstruction, standard biventricular repair carries high risk of atrioventricular block. This single-center review included nine patients (median age, 5 years) treated with a restrictive left ventricle-to-pulmonary artery conduit without VSD closure. Over a median 12.5 years, there were no deaths and no pacing for heart block. Ten-year freedom from reintervention was 62.5 percent; eight patients were New York Heart Association Class I or II, and left ventricular (LV) function was preserved in all. This approach appears to be a safe biventricular option.