Document Detail

Selective timing for the arterial switch operation.
MedLine Citation:
PMID:  15111168     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To determine outcomes for the arterial switch operation individualized according to the underlying anatomy and clinical status. METHODS: A retrospective review of a consecutive series of infants less than 90 days of age who underwent the arterial switch operation at a single institution. RESULTS: From July 1993-April 2001, 117 infants underwent an arterial switch operation before 90 days of age. Seventy-five patients (64%) had transposition of the great arteries with intact ventricular septum with the aim of operation before 14 days of age; however, 8 of these patients had delayed presentation (range 15-46 days). Thirty-five patients (30%) had transposition with a ventricular septal defect (30 patients) or double outlet right ventricle (5 patients) and normal arch anatomy and were repaired within the first 90 days of life depending on the severity of heart failure at a median of 12 days of age (range 3-83 days). Seven patients (6%) had associated aortic coarctation (5 patients) or interrupted aortic arch (2 patients). One patient died during hospitalization (0.85% hospital mortality) and one patient died from noncardiac causes during a median follow-up of 35 months (1.7% total mortality). Four patients required intervention during follow-up (3.4%) for new aortic coarctation (2 patients), supravalvar pulmonic stenosis (1 patient), or right hemi-diaphragm paralysis (1 patient). CONCLUSIONS: Individualized timing for the arterial switch operation within the first ninety days of life produces excellent survival rates for all types of transposition physiology with the expectation of a satisfactory course during follow-up.
Brian W Duncan; Nancy C Poirier; Roger B B Mee; Jonathan J Drummond-Webb; Athar Qureshi; C Igor Mesia; June A Graney; Cheryl L Malek; Larry A Latson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  77     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-27     Completed Date:  2004-06-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1691-6; discussion 1697     Citation Subset:  AIM; IM    
Department of Pediatric and Congenital Heart Surgery, The Children's Hospital at The Cleveland Clinic, Cleveland, Ohio 44195, USA.
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MeSH Terms
Coronary Vessel Anomalies / complications
Double Outlet Right Ventricle / complications,  surgery
Heart Septal Defects, Ventricular / complications,  surgery
Infant, Newborn
Postoperative Complications
Respiration, Artificial
Retrospective Studies
Transposition of Great Vessels / complications,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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