The Bentall Procedure on the Anatomic Right Ventricular Outflow Tract for Posterior Transposition of the Great Arteries

The patient was a 21-year-old male who underwent the Jatene procedure at 5 months of age for posterior transposition of the great arteries (double-outlet right ventricular type). At 4 years of age, the patient underwent mechanical aortic valve replacement with aortic root augmentation using an expanded polytetrafluoroethylene patch for severe neo-aortic regurgitation. Mechanical valve failure occurred due to pannus formation. We performed the Bentall procedure on the aortic root, which involved the pulmonary artery and a severely calcified expanded polytetrafluoroethylene patch. A composite graft was safely positioned on the anatomic right ventricular outflow tract aortic root under four-dimensional imaging guidance.