A novel conduit-lengthening technique to facilitate the arterial switch operation in an infant with a problematic combination of coronary anomolies.

We report the technical aspects of the arterial switch operation as we performed it in a 5-month-old infant who had situs inversus, dextrocardia, transposition of the great arteries, and inverted origin of the circumflex and right coronary arteries. The successful performance of this procedure required the use of a conduit-lengthening technique due to the much longer distance to the proposed site of coronary artery transfer.