Korean J Pediatr.  2012 Oct;55(10):377-382. 10.3345/kjp.2012.55.10.377.

Clinical features and surgical outcomes of complete transposition of the great arteries

• Hong SJ
• Choi HJ
• Kim YH
• Hyun MC
• Lee SB
• Cho JY

• KMID: 2140713
• DOI: http://doi.org/10.3345/kjp.2012.55.10.377

Abstract

PURPOSE
This single-center study aimed to assess the clinical features and surgical approaches and outcomes of complete transposition of the great arteries (TGA).
METHODS
TGA patients who had undergone surgical correction at the Kyungpook National University Hospital from January 2000 to December 2010, were retrospectively evaluated for patient characteristics, clinical manifestation, preoperative management, intraoperative findings, postoperative progress, and follow-up status.
RESULTS
Twenty-eight patients (17 boys and 11 girls, mean age=10.6+/-21.5 days) were included and were categorized as follows: group I, TGA with intact ventricular septum (n=13); group II, TGA with ventricular septal defect (VSD, n=12); and group III, TGA/VSD with pulmonary stenosis (n=3). Group I underwent the most intensive preoperative management (balloon atrial septostomy and prostaglandin E1 medication). Group II showed the highest incidence of heart failure (P<0.05). Usual and unusual coronary anatomy patterns were observed in 20 (71%) and 8 patients, respectively. Arterial and half-turned truncal switch operations were performed in 25 and 3 patients (Group III), respectively. Postoperative complications included cardiac arrhythmias (8 patients), central nervous system complications (3 patients), acute renal failure (1 patient), infections (3 patients), and cardiac tamponade (1 patient), and no statistically significant difference was observed between the groups. Group II showed the mildest aortic regurgitation on follow-up echocardiograms (P<0.05). One patient underwent reoperation, and 1 died. The overall mortality rate was 4%.
CONCLUSION
Our study showed favorable results in all the groups and no significant difference in postoperative complication, reoperation, and mortality among the groups. However, our results were inadequate to evaluate the risk factors for reoperation and mortality owing to the small number of patients and short follow-up duration.

Keyword

Dextro-looped transposition of the great arteries; Postoperative complications; Reoperation; Mortality

MeSH Terms

Acute Kidney Injury
Alprostadil
Aortic Valve Insufficiency
Arrhythmias, Cardiac
Arteries
Cardiac Tamponade
Central Nervous System
Follow-Up Studies
Heart Failure
Heart Septal Defects, Ventricular
Humans
Incidence
Postoperative Complications
Pulmonary Valve Stenosis
Reoperation
Retrospective Studies
Risk Factors
Transposition of Great Vessels
Ventricular Septum
Alprostadil