{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T22:05:02Z","timestamp":1771970702831,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The Bex-Nikaidoh operation can effectively relieve left ventricular outflow tract obstruction. However, if a conduit is used for right ventricular outflow tract reconstruction, a late reoperation can be anticipated. We examined the impact of double root translocation on outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We performed a retrospective single-centre study of patients who underwent aortic root translocation between 2006 and 2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Aortic root translocation was performed in 23 patients at a median age of 1.6\u2009years [interquartile range (IQR) 0.9\u20132.5]. Concomitant repairs were done in 52.2% of patients (12\/23) including the Senning atrial switch in 34.8% (8\/23). The right ventricular outflow tract was reconstructed with valved conduits in 39.1% (9\/23), direct anastomoses in 4.35% (1\/23) and pulmonary autografts in 56.5% of patients (13\/23). Aortic cross-clamp time was significantly longer in patients with double root translocation [308\u2009min (IQR 270\u2013259) vs 209\u2009min (IQR 179\u2013281), P\u2009=\u20090.02]; 2 patients in this group required temporary mechanical circulatory support. There were no early deaths. Median follow-up time was 7.5\u2009years (IQR 3.3\u201310.5). The estimated 10-year survival was 90% [95% confidence interval (CI): 47.3%, 98.5%]. There was no recurrent left ventricular outflow tract obstruction. Freedom from any reoperation was 64.2% (95% CI: 40.8%, 80.3%) at 3\u2009years and 44.5% (95% CI: 21.2%, 65.5%) at 6\u2009years. The main indication for late reoperation was conduit degeneration. Freedom from a right ventricular outflow tract reoperation was significantly higher, and the number of reoperations per patient was lower when a double root translocation had been performed (P\u2009=\u20090.03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The Bex-Nikaidoh operation effectively relieved left ventricular outflow tract obstruction. A double root translocation further increased procedural complexity but was associated with better mid-term freedom from a right ventricular outflow tract reoperation. It should be considered in suitable patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad407","type":"journal-article","created":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T16:39:51Z","timestamp":1702226391000},"source":"Crossref","is-referenced-by-count":4,"title":["Bex-Nikaidoh operation and the impact of double root translocation on outcomes"],"prefix":"10.1093","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9155-9509","authenticated-orcid":false,"given":"Antonia","family":"Schulz","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Royal Children\u2019s Hospital , Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Buratto","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Royal Children\u2019s Hospital , Melbourne, Australia"},{"name":"Department of Paediatrics, University of Melbourne , Melbourne, Australia"},{"name":"Heart Research Group, Murdoch Children\u2019s Research Institute , Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuta","family":"Ishigami","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Royal Children\u2019s Hospital , Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor E","family":"Konstantinov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Royal Children\u2019s Hospital , Melbourne, Australia"},{"name":"Department of Paediatrics, University of Melbourne , Melbourne, Australia"},{"name":"Heart Research Group, Murdoch Children\u2019s Research Institute , Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael M H","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne , Melbourne, Australia"},{"name":"Heart Research Group, Murdoch Children\u2019s Research Institute , Melbourne, Australia"},{"name":"Department of Cardiology, Royal Children\u2019s Hospital , Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian P","family":"Brizard","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Royal Children\u2019s Hospital , Melbourne, Australia"},{"name":"Department of Paediatrics, University of Melbourne , Melbourne, Australia"},{"name":"Heart Research Group, Murdoch Children\u2019s Research Institute , Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"2024031016495161200_ezad407-B1","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0022-5223(19)42568-3","article-title":"Anatomic correction of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis","volume":"58","author":"Rastelli","year":"1969","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024031016495161200_ezad407-B2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1017\/S104795110000010X","article-title":"R\u00e9paration \u00e0 l\u2019Etage Ventriculaire\u2013The REV procedure: technique and clinical results","volume":"1","author":"Lecompte","year":"1991","journal-title":"Cardiol Young"},{"key":"2024031016495161200_ezad407-B3","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/S0003-4975(10)61636-0","article-title":"Anatomical Correction of Transposition of the Great Arteries","volume":"29","author":"Bex","year":"1980","journal-title":"Ann Thorac Surg"},{"key":"2024031016495161200_ezad407-B4","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0022-5223(19)38323-0","article-title":"Aortic translocation and biventricular outflow tract reconstruction. 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