Arterial switch operation in non-facing coronary artery ostium.

The arterial switch operation was performed on a 38-day-old infant with d-transposition of the great arteries and abnormal origin of the left anterior descending and right coronary arteries from a non-facing sinus. A vertical aortic tube flap was established to lengthen the abnormally originating coronary arteries, by transecting part of the ascending aorta 2 cm above the coronary orifices. Both coronary arteries were transferred to the neoaortic root in a single extended tube.