At the National Scientific Medical Center, a high-tech surgical intervention was successfully performed on a patient born in 2022 with a rare congenital heart defect corrected transposition of the great arteries (CCTGA).
This is a complex anomaly in which the atrioventricular connection is inverted: the right atrium connects to the morphologic left ventricle, and the left atrium to the morphologic right ventricle. The ventriculo-arterial connection is also inverted: the morphologic left ventricle is connected to the pulmonary artery, and the right ventricle to the aorta. Despite the double level of transposition, the blood flow remains physiologically correct venous blood flows to the lungs, and arterial blood to the systemic circulation. However, the morphologic right ventricle, which is naturally suited for low-pressure circulation, is forced to handle systemic workload. This can lead to progressive systolic dysfunction and heart failure.
The first stage of treatment was performed at the age of 9 months, when the child underwent pulmonary artery banding to prepare the myocardium for future systemic load.
On June 13, 2025, the cardiac surgery team performed a radical correction the Double Switch operation along with the simultaneous implantation of a dual-chamber pacemaker. The surgery included two key stages: the Senning procedure (atrial-level venous redirection) and the Jatene procedure (arterial switch at the level of the great vessels), which allowed restoration of the anatomically correct direction of blood flow. The total duration of the operation was approximately six hours, with aortic cross-clamping time lasting two hours. Intraoperative transesophageal echocardiography confirmed stable hemodynamics and satisfactory myocardial contractility.
Preparation for the intervention involved multiple stages. Specialists of the center conducted a detailed clinical analysis and held consultations with leading international experts.
This was especially emphasized by the Director of the Pediatric Cardiac Surgery Center, Amangeldy Kerimkulov, who highlighted the high level of organization and professionalism of the entire team.
The surgical team included: cardiac surgeon and head of the Pediatric Congenital Heart Disease Surgery Department, Nurkeev Bakytzhan Abidullayevich; senior resident of the pediatric cardiac surgery unit, Tuyakbayev Bauyrzhan Myrzabayevich; pediatric cardiac surgeon Aldabergenov Yerbol Nurlanuly; the anesthesiology and intensive care team led by the Head of the Department of Anesthesiology, Resuscitation and Therapy of the Pediatric Cardiac Surgery Unit, Kabakanova Asel Khanatovna; attending pediatric cardiologist Kenzhebayeva Araylym Orynbekovna; as well as the nursing staff of the Center.
The patient is now three years old. Ahead lies a period of recovery, postoperative monitoring, and rehabilitation. Thanks to precise diagnostics, teamwork, and modern surgical capabilities, the child has the chance to live a full and healthy life.
We express our sincere gratitude to all the specialists involved in the preparation and execution of the operation for their dedication to their profession and daily efforts for the health of children.
