Korean J Pediatr.  2009 Aug;52(8):910-916. 10.3345/kjp.2009.52.8.910.

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

• Cho MJ
• Park JA
• Lee HD
• Sung SC
• Choo KS

• KMID: 2281591
• DOI: http://doi.org/10.3345/kjp.2009.52.8.910

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.

Keyword

Great Vessels Transposition; Postoperative Complication

MeSH Terms

Aorta, Thoracic
Arteries
Constriction, Pathologic
Double Outlet Right Ventricle
Follow-Up Studies
Hand
Hospital Mortality
Humans
Postoperative Complications
Pulmonary Artery
Retrospective Studies
Risk Factors
Transposition of Great Vessels
Ventricular Septum