The clinical research of double switch operation with Glenn and hemi-Mustard in CC-TGA in children
10.3760/cma.j.issn.1001-4497.2017.12.001
- VernacularTitle:小儿ccTGA解剖纠治术中应用双向Glenn/半Mustard心房调转双调转手术的初步研究
- Author:
Jinghao ZHENG
1
;
Zhongqun ZHU
;
Qi SUN
;
Botao GAO
;
Xinwei DU
;
Zhiwei XU
;
Jinfen LIU
Author Information
1. 200127,上海交通大学医学院附属上海儿童医学中心心胸外科
- Keywords:
Corrected transposition of great arteries;
Hemi-Mustard procedure;
Double switch procedure
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2017;33(12):705-707
- CountryChina
- Language:Chinese
-
Abstract:
Objective To avoid complications associated with the complete Senning procedures and to assist right-heart hemodynamics, this study was undertaken to assess the risks and benefits of the double-switch operation using a hemi-Mustard atrial switch procedure and the bidirectional Glenn operation for congenitally corrected transposition of the great arteries. we fa-vor a modified atrial switch procedure. Methods Between January 2014 and March 2016, anatomic repair was achieved in 26 patients. A hemi-Mustard procedure was the atrial switch procedure for 26. 9％(7/26). The Rastelli-atrial switch procedure was performed in 5 patients( RAS) and the arterial-atrial switch procedure was performed in 2 patients( AAS) . Results There was no in-hospital death after anatomic repair. There were no late deaths in a median follow-up of 7-21 months. Glenn opera-tion complications were uncommon limited to the perioperative period, atrial baffle-related reoperations or sinus node dysfunc-tion had not been observed. Tricuspid regurgitation decreased to mild for 1 case and mild to moderate for 6 cases. Right ventri-cle-pulmonary artery conduit longevity was significantly improved. Conclusion We recentely describe an experience with the double-switch operation using a modified atrial switch procedure with favorable earlyterm results. The risks of the hemi-mustard and bidirectional Glenn operation are minimal and are limited to a well-defined patient subset. The benefits include reduced baffle-and sinus node-related complications, technical simplicity and inspiring results.
