Recent experience with the arterial switch operation in transposition of the great arteries.

Détails

ID Serval
serval:BIB_B7DE7CD8ED88
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Recent experience with the arterial switch operation in transposition of the great arteries.
Périodique
Schweizerische Medizinische Wochenschrift
Auteur(s)
Prêtre R., Ye Q., Fasnacht M., Schmidlin D., Vogt P., Turina M.
ISSN
0036-7672 (Print)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
1999
Peer-reviewed
Oui
Volume
129
Numéro
40
Pages
1443-1449
Langue
anglais
Résumé
OBJECTIVE: Review of our experience with the technically demanding arterial switch operation in transposition of the great arteries in children.
METHODS: Twenty-seven children who underwent an arterial switch operation in our clinic were retrospectively reviewed. Except for one child (operated on at eight months), the operation was performed during the neonatal period. The underlying pathology was d-transposition of the great arteries in 25 children and a double outlet right ventricle of transposition type in 2. Five children had an associated ventricular septum defect and 1 aortic isthmus coarctation. The pattern of the coronary arteries was favourable in 18 children, difficult in 7 and dangerous in 3. The operation was performed in cardiopulmonary bypass for repair of the transposition and in a period of deep hypothermic circulatory arrest for repair of the intracardiac defects.
RESULTS: One child died perioperatively and 1 postoperatively (operative mortality 7%) from myocardial ischaemia following unsuccessful transfer of a dangerous pattern of coronary arteries. Another child, a low-birth weight baby, died 80 days after the operation from respiratory failure. Postoperative morbidity occurred in 10 patients and medium-term morbidity in 6 patients who presented various degrees of stenosis of a pulmonary artery. During a median follow-up of 18 months no patient required reoperation. The children are asymptomatic and thriving satisfactorily.
CONCLUSION: Because it restores the heart physiology, the arterial switch operation is considered the procedure of choice for correction of transposition of the great arteries. The operation involves acceptable mortality and morbidity. Transfer of difficult coronary artery patterns and development of stenosis on the pulmonary arteries remain problematic.
Pubmed
Web of science
Création de la notice
16/12/2014 19:05
Dernière modification de la notice
20/08/2019 15:25
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