Early Results of the Arterial Switch Operation in Neonates.
- Author:
Si Chan SUNG
1
;
Jung Hee BANG
;
Seung Hwan PYUN
;
Hee Jae JUN
;
Kwang Jo JO
;
Pil Jo CHOI
;
Chong Su WOO
;
Hyoung Doo LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, College of Medicine, Dong-A University, Korea.
- Publication Type:Original Article
- Keywords:
Arterial switch operation;
Transposition of great vessels;
Neonate
- MeSH:
Aortic Valve;
Arteries;
Body Weight;
Double Outlet Right Ventricle;
Echocardiography;
Follow-Up Studies;
Heart;
Heart Septal Defects, Ventricular;
Hospital Mortality;
Humans;
Incidence;
Infant, Newborn*;
Mortality;
Pulmonary Valve Stenosis;
Retrospective Studies;
Risk Factors;
Survivors;
Transposition of Great Vessels;
Ventricular Septum
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1998;31(10):931-938
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Anatomic correction of transposition of the great arteries by means of the arterial switch operation is now accepted as the therapeutic method of choice. This retrospective study attempts to assess the results of the neonatal arterial switch operation for transposition of the great arteries performed by our newly established institution. MATERIALS AND METHODS: 33 consecutive neonates underwent the arterial switch operation between October 1991 to November 1997. There were 27 neonates with transposition and intact ventricular septum, 3 with ventricular septal defect, and 3 with Taussig-Bing anomaly. The mean age was 10.9+/-7.9 days and mean body weight was 3.29+/-0.44kg. RESULTS: Overall postoperative hospital mortality was 30.3% (10 patients). The mortality has improved with time; 75% (6 patients) among first 8 consecutive patients before 1994, 20% (2 patients) among 10 patients in 1994 and 1995, and 13.3% (2 patients) among 15 patients since 1996. Univariated analysis of risk factors revealed that earlier date of the operations and one of preoperative events were determinants for operative death. There were two late deaths. A mean follow-up of 17.4+/-16.5 months was achieved in all 21 survivors. All were in New York Heart Association functional class I. One patient had mild pulmonary stenosis and two had mild aortic valve regurgitation on their echocardiography. CONCLUSIONS: We concluded that we should continue to perform arterial switch operation for neonates with transposition of the great arteries because the mortality of the operation has been improved and the operative survivors have good functional results with low incidence of late complications.
