Follow-up Study after Atrial Switch Operation for Complete Transposition of the Great Arteries.
10.4070/kcj.1998.28.5.683
- Author:
Youn Woo KIM
;
Chung Il NOH
;
June HUH
;
Myung Ja YUN
;
Ho Sung KIM
;
Jung Yun CHOI
;
Yong Soo YUN
;
Sei Won YANG
;
Jeong Ryul LEE
;
Yong Jin KIM
;
Joon Ryang RHO
- Publication Type:Original Article
- Keywords:
Transposition of the great arteries;
Atrial switch operation
- MeSH:
Angiotensin-Converting Enzyme Inhibitors;
Arteries*;
Atrial Flutter;
Digoxin;
Female;
Follow-Up Studies*;
Furosemide;
Heart;
Humans;
Male;
Mortality;
Mustard Plant;
Postoperative Complications;
Retrospective Studies;
Seoul;
Sick Sinus Syndrome;
Survival Rate;
Survivors;
Tricuspid Valve Insufficiency;
Ventricular Premature Complexes
- From:Korean Circulation Journal
1998;28(5):683-690
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Since the introduction of atrial switch operation, the outlook for patients with complete transposition of the great arteries (TGA) has improved dramatically. However, many survivors are afflicted with postoperative complications and continue to demand medical attention. We therefore performed the study for the evaluation of the clinical course in the patients with complete TGA after atrial switch operation. METHODS: We analyzed the data of 51 patients who underwent the atrial switch operation for complete TGA at Seoul National University Hospital between January 1981 and June 1993 retrospectively. RESULTS: The patients were composed of 36 males and 15 females (mean age at operation, 15+/-30 months, range 2 months-18 years). Senning operation was undertaken in 43 and Mustard operation in 8. Among these, 27 had simple and 24 complex complete TGA. The early mortality rate within 1 month postoperatively was 39% and the late mortality rate 16%. The actuarial survival rate after 10 years was 78%. Of these, 17 cases have been followed up so far. Although the significant tricuspid regurgitation was noted in 9, right ventricular systolic function was maintained in all of them. Preoperative sinus node dysfunction was noted in 1 case. Postoperatively, premature ventricular contractions were found in 8 cases, atrial flutter in 4, and sinus node dysfunction in 7. Subclinical pulmonary venous obstruction was found in 2 and systemic venous obstruction in 1. At present, one takes digoxin for prevention of atrial flutter and 7 take digoxin, furosemide, and/or angiotensin-converting enzyme inhibitors for prevention of ventricular functional deterioration. Twelve cases were in New York Heart Association functional class I at the latest follow-up and 5 were in class II. CONCLUSION: This study revealed that morbidity and mortality were not low after atrial switch operation. However, considering the good long-term functional status in the survivors, atrial switch operation could be an alternative to arterial switch operation in complicated cases of TGA.
