| Results of the double switch operation for congenitally corrected transposition of the great arteries. | |
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MedLine Citation:
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PMID: 19346135 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Congenitally corrected TGA (CC-TGA) is characterized by discordant atrioventricular and ventriculo arterial connections. In absence of right ventricular outflow tract obstruction (RVOTO), repair by atrial and arterial switches remains a challenging procedure for which long term follow-up is uncertain. METHODS: From 1995 to 2007, 20 patients (median age: 26 months) with CC-TGA had double switch procedure. Segmental anatomy was {SLL} in all patients, dextrocardia in two patients, mesocardia in two patients. Ventricular septal defect was present in 17 patients, aortic coarctation in 2 patients and interrupted aortic arch (IAoA) in 1 patient. Five patients had tricuspid valve regurgitation. Six patients had AV blocks, 4 patients had pacemaker implantation prior to repair. Pulmonary artery banding was performed in 17 patients, for congestive heart failure (14 patients) or left ventricular retraining (3 patients). Three patients, including one patient with IAoA had primary repair. After LV retraining, repair was performed when indexed LV mass to LV volume ratio was above 1.5. A median follow-up of 60 months was achieved in all. RESULTS: There were no deaths. Postoperative pacemaker implantation was required in four patients. Reoperation for Senning obstruction was necessary in one patient, and pacemaker battery replacement in another patient. One patient had mild neoaortic insufficiency, two had mild tricuspid regurgitation and two had mild mitral regurgitation. All were in NYHA I-II. Actuarial survival at 10 years was 100% and freedom from reoperation at 5 and 10 years were 93% and 77.4%, respectively. CONCLUSION: Double switch for CC-TGA without RVOTO can be performed with no mortality and low morbidity. Since these results seem to last for several years, it should be considered as the optimal procedure. |
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Authors:
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Mohamedou Ly; Emre Belli; Bertrand Leobon; Chokri Kortas; Oswin E Grollmüss; Dominique Piot; Claude Planché; Alain Serraf |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2009-04-05 |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 35 ISSN: 1873-734X ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-27 Completed Date: 2009-11-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 879-83; discussion 883-4 Citation Subset: IM |
Affiliation:
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Department of Pediatric Cardiac Surgery, Marie Lannelongue Hospital, University of Paris-Sud, Le Plessis-Robinson, France. ly_mohamed@yahoo.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms Cardiac Pacing, Artificial Child Child, Preschool Echocardiography, Doppler Epidemiologic Methods Heart Block / complications, therapy Heart Septal Defects, Ventricular / complications Humans Infant Reoperation Transposition of Great Vessels / complications, surgery*, ultrasonography Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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