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Figure 3: Ross-switch-Konno procedure. The aortic autograft is excised, and the coronaries are mobilized; the main pulmonary artery is transected and an incision is extended across the pulmonary valve annulus and outlet septum connecting to the ventricular septal defect accomplished by insertion of a triangular-shaped VSD patch. The aortic autograft is re-inserted into the left ventricular outflow. The aortic root autograft is then rotated 180° so that the defects from the coronary buttons face anteriorly. The coronaries are then reimplanted. Before reestablishing ascending aortic continuity, the branch pulmonary arteries are mobilized and brought anterior to the aorta (Lecompte maneuver) in preparation for right ventricular outflow reconstruction (reproduced with permission from Bautista-Hernandez et al.[24])

Figure 3: Ross-switch-Konno procedure. The aortic autograft is excised, and the coronaries are mobilized; the main pulmonary artery is transected and an incision is extended across the pulmonary valve annulus and outlet septum connecting to the ventricular septal defect accomplished by insertion of a triangular-shaped VSD patch. The aortic autograft is re-inserted into the left ventricular outflow. The aortic root autograft is then rotated 180° so that the defects from the coronary buttons face anteriorly. The coronaries are then reimplanted. Before reestablishing ascending aortic continuity, the branch pulmonary arteries are mobilized and brought anterior to the aorta (Lecompte maneuver) in preparation for right ventricular outflow reconstruction (reproduced with permission from Bautista-Hernandez <i>et al</i>.<sup>[24]</sup>)