| Outcomes of the arterial switch operation in complete transposition of the great arteries |
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Min Jung Cho1, Ji Ae Park1, Hyoung Doo Lee1, Si Chan Sung2, Ki Seok Choo3 |
1Department of Pediatrics, Pusan National University Children`s Hospital
2Department of Thoracic and Cardiovascular Surger, Pusan National University Children`s Hospital
3Department of Radiology, Pusan National University Children`s Hospital |
| 완전 대혈관 전위에서 대혈관 치환술 후의 예후 |
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조민정1, 박지애1, 이형두1, 성시찬2, 추기석3 |
1부산대학교 어린이병원 소아과학교실
2부산대학교 어린이병원 흉부외과학교실
3부산대학교 어린이병원 영상의학과학교실 |
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| Abstract |
Purpose
The arterial switch operation (ASO) has become the preferred procedure for the surgical management of transposition
of the great arteries (TGA). We conducted a retrospective evaluation of our experience in 30 patients seen from January
2003 to July 2008, in order to determine outcomes and related risk factors after the arterial switch operation.
Methods
Patients charts, surgical reports, and echocardiograms were retrospectively reviewed. And they were analyzed in
2 different groups: complex (n=16) versus simple TGAs (n=14). Complex TGAs are TGAs with VSD or the Taussig-Bing anomaly
with or without aortic arch anomalies. Simple TGAs are defined as TGAs with intact ventricular septum having no such anomalies.
Median follow-up time was 44 months (3-63 months).
Results
Hospital mortality was 0%. However, follow-up echocardiographies revealed potential complications, including stenosis
of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, and right or left ventricular outflow
tract obstructions. Great arterial relationship (side-by-side), association of aortic arch anomalies, and the existence of the Taussig-
Bing anomaly were assessed as significant risk factors of neo-aortic and/or neo-pulmonary valvar regurgitation in this series.
On the other hand, right or left ventricular outflow tract obstructions were more frequently found in patients demonstrating VSD,
side-by-side positioned great arteries, or associated coronary anomalies.
Conclusion
The ASO is the procedure of choice in the treatment of TGA. However, special attention and follow-ups are
needed to detect residual problems like the stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar
regurgitation, as well as ventricular outflow tract obstructions. |
| Key Words:
Great Vessels Transposition, Postoperative Complication |
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