The operative strategy after palliative shunt for corrected transposition of great artery (cTGA) with left ventricular outflow tract obstruction and cardiac malpostion
- VernacularTitle:合并异位心及左室流出道狭窄的矫正型大动脉转位分流术后再次手术策略研究
- Author:
Rui LIU
1
;
Kunjing PANG
1
;
Shoujun LI
1
;
Benqing ZHANG
1
;
Lu RUI
1
;
Ye LIN
1
;
Kai MA
1
;
Hanmei LI
1
Author Information
1. Department of Pediatric Cardiac Surgery of Fuwai Hospital, National Center for Cardiovdscular Diseases, Beijing Union Medical College, Chinese Academy of Medical Sciences, 100037, Beijing, P.R.China
- Publication Type:Journal Article
- Keywords:
Cardiac malpositon;
corrected transposition of great artery (cTGA);
secondary surgery;
left ventricular outflow tract obstruction
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(04):447-452
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the operative strategy after palliative shunt for correcting congenitally corrected transposition of great artery (cTGA) patients with left ventricular outflow tract obstruction (LVOTO) and cardiac malpostion. Methods We retrospectively analyzed the clinical data of 54 patients with onsecutive cTGA with LVOTO and cardiac malpositon from June 2011 to May 2019. The patients were devided into two groups. There were 24 patients (16 males and 8 females at mean age of 5.4±2.2 years) who underwent one and a half ventricle repair as a one and half ventricle group. And there were 30 patients (19 males and 11 females at age of 8.6±6.2 years) who underwent one ventricle repair operation as a one ventricle group. Follow-up data were collected by telephone interviews. Results There was no statistical difference in systemic atrioventricular valve regurgitation and systemic ventricular ejection fraction between the two groups (P>0.05). Compared with one and a half ventricle group, the cardiopulmonary bypass time (CPB) time, mechanical ventilation time and intensive care unit stay were significant shorter than those in the one ventricle group (P<0.05), but prolonged pleural effusions developed more frequently in the one ventricle repair group (P<0.05). There was no in-hospital death but 1 follow-up death in each group. The follow-up time was 49 (17-38) months in the one and half ventricle group at follow-up rate of 93.9%, and 47 (12-85) months at follow-up rate at 90.9% in the one ventricle group. One and a half ventricle group had better systemic ventricular ejection fraction (EF) than that in the one ventricle repair group. And the rate of heart function (NYHA) class Ⅲ and class Ⅳ in one and a half ventricle group was lower than that in the ventricle group. No significant difference of survival and freedom from re-intervention probability between the two groups was found. Conclusion For patients of correction of cTGA with LVOTO and cardiac malposition after palliative shunt, the one-and-a-half ventricular repair procedure is ideal operative strategy.
