All issues > Volume 52(8); 2009

Original Article

Korean J Pediatr. 2009;52(8):910-916. Published online August 15, 2009.

Outcomes of the arterial switch operation in complete transposition of the great arteries

Min Jung MJ Cho¹, Ji Ae JA Park¹, Hyoung Doo HD Lee¹, Si Chan SC Sung², Ki Seok KS Choo³

¹Department of Pediatrics, Pusan National University Children`s Hospital
<sup>2</sup>Department of Thoracic and Cardiovascular Surger, Pusan National University Children`s Hospital
³Department of Radiology, Pusan National University Children`s Hospital

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.

Keywords :Great Vessels Transposition, Postoperative Complication