Pulmonary Root Translocation

The pulmonary artery and the aorta are the main arteries leaving the heart. The root is where each of these arteries connect to the heart. In some congenital heart defects, the pulmonary artery is connected to the heart in the wrong location, and it can be smaller than normal, which is called pulmonary stenosis.

Placing a conduit (artificial tube) to replace a valve or artery that is too small is a part of the solution for repairing these types of heart defects, but artificial conduits can fail or wear out over time and need to be surgically replaced. At the Betty Irene Moore Children’s Heart Center at Stanford Medicine Children’s Health, we can offer pulmonary root translocation, using you/your child’s natural anatomy for a longer-lasting solution. Specifically, our approach avoids a type of artificial tube called an RV-PA (right ventricle to pulmonary artery) conduit by moving the pulmonary root to a better location, even if it is small. When a child’s native tissue is used instead of a conduit, the tissue can grow along with the heart as the child grows. In this way, we help avoid future heart surgeries.

Pulmonary root translocation is a complex biventricular reconstruction that is performed for the following conditions:

Dextro-transposition of the great arteries (d-TGA) occurs when the two main arteries, the pulmonary artery and the aorta, are switched in position. Pulmonary stenosis complicates this condition because the blood vessel to the lungs is smaller than normal, and the standard repair cannot be performed.

Double outlet right ventricle (DORV) is a rare congenital heart defect where the pulmonary artery and the aorta both come from the right side of the heart, or ventricle, rather than the aorta coming from the left ventricle. When there is pulmonary stenosis, an RV-PA conduit (artificial tube) is necessary in the repair and will require surgical replacement over time. A pulmonary root translocation instead of an RV-PA conduit avoids the need for future surgical conduit replacements.

Congenitally corrected transposition of the great arteries (CCTGA) is a rare heart defect where the two heart ventricles are reversed, as are their roles, leaving the weaker right ventricle to pump blood to the body. When there is pulmonary stenosis, an RV-PA conduit (artificial tube) is often necessary in the repair and will require surgical replacement over time. A pulmonary root translocation instead of an RV-PA conduit avoids the need for future surgical conduit replacements.