Mid-term morbidity and mortality of patients after arterial switch operation in infancy for transposition of the great arteries
| Autor: | Luisa Cabeza-Letrán, José Santos de Soto, Pilar Pérez, Antonio Álvarez Madrid, Antonio Pelaez Gonzalez, Pastora Gallego, Manuela Romero-Vazquiánez, Reza Hosseinpour, Mauro Gil Fournier, María José Rodríguez Puras |
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| Rok vydání: | 2013 |
| Předmět: |
Aortic arch
Heart Septal Defects Ventricular Male medicine.medical_specialty Percutaneous Transposition of Great Vessels Postoperative Complications Internal medicine medicine.artery medicine Humans Cardiac Surgical Procedures Retrospective Studies Surgical approach Ejection fraction business.industry Infant Newborn General Medicine Perioperative Neoaortic root Surgery Great arteries Cardiology Functional status Female business |
| Zdroj: | Revista espanola de cardiologia (English ed.). 67(3) |
| ISSN: | 1885-5857 |
| Popis: | Introduction and objectives The arterial switch operation is currently the preferred surgical approach for complete transposition of the great arteries. We sought to determine the mid-term results of this intervention. Methods A single-institution retrospective review of clinical records of all consecutive patients who underwent the arterial switch surgery between 1985 and 2010. Results Overall, the operation was performed on 155 patients (68% boys) at a median age of 13 days: 64% with an intact septum, 46% with a ventricular septal defect, and 4.5% with associated aortic arch anomaly. The usual coronary pattern was found in 63%. Palliative surgery was performed prior to arterial switch in 6.5%. In all, 137 perioperative survivors were followed for a median of 6 years. Late mortality was 2.9%, of which 50% was due to coronary complications. Eighteen percent required surgical and/or percutaneous reintervention: 95.6% for right-sided obstruction and 4.3% for aortic regurgitation. At last follow-up, 92% had functional class I symptoms and 95% were free of arrhythmias. The left ventricular ejection fraction was greater than 55% in 95%, 28% had neoaortic regurgitation (78% mild regurgitation), and 31% had right ventricular outflow tract obstruction with a mean gradient according to echocardiography greater than 25 mmHg. Conclusions Mid-term survival of patients after arterial switch operation is excellent and their functional status is good. However, a few patients have residual lesions and a need for further intervention during follow-up, mostly for right-sided obstructions. Late mortality was uncommon and was related to coronary complications. Neoaortic root dilation and regurgitation are not major issues in early adulthood, but the long-term course of these lesions is still unknown. |
| Databáze: | OpenAIRE |
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