Results of the two-stage arterial switch operation in 49 patients with transposition of the great arteries, performed between January 1995 and September 2000, were reviewed retrospectively. Twenty-one patients had a ventricular septal defect. Anatomical correction was carried out 21.89 +/- 9.86 months after pulmonary artery banding, with or without a modified Blalock-Taussig shunt. Hospital mortality was 8% (4 patients). During follow-up of 30.12 +/- 14.38 months, there was 1 late death and 1 patient required reoperation for pseudoaneurysm of the ascending aorta. Actuarial survival and freedom from reoperation at 5 years were 90% and 97%, respectively. Late anatomic correction (> 6 months) after the preliminary procedure can be performed with an acceptable mortality and morbidity, but undue delay may lead to left ventricular dysfunction, arrhythmias, and new aortic valve regurgitation or subaortic stenosis.
Primary repair of complete atrioventricular canal in patients who present beyond one year of age carries a high mortality. Between January 1995 and February 2000, 16 patients aged 8 to 24 months (mean, 14.5 months) received pulmonary artery banding at presentation and underwent total correction at 24 to 96 months old (mean, 41.9 months). There was one hospital death (mortality, 6.25%). During a mean follow-up of 10.2 months (range, 6 to 28 months), there was no late death, 13 of the 15 survivors (87%) were in New York Heart Association functional class I, and 2 (13%) were in class III. In patients with complete atrioventricular canal who present late with severe reactive pulmonary hypertension, banding followed by complete repair reduces the risk associated with primary repair.
Aortopulmonary window is an uncommon anomaly. Early surgery is recommended before permanent pulmonary vascular changes develop. Results were reviewed in 18 patients who underwent aortopulmonary window repair between January 1985 and December 1999. A transaortic approach was employed in 12, a transpulmonary approach was used in 3, the pulmonary artery flap technique was performed in 2, and an aortopulmonary window was simply ligated in 1 patient. Concomitant repair of all associated anomalies was carried out, except in 2 patients who had interrupted aortic arch repaired 6 days before aortopulmonary window repair. There was no hospital mortality. During a mean follow-up of 43 months (range, 6 to 144 months), there was no late death and all patients were in New York Heart Association functional class I, except 3 who required reoperation: 2 had pulmonary artery confluence stenosis 5 to 10 years after aortopulmonary window repair; and 1 required transfer of the right coronary artery from the pulmonary artery to the aorta 28 months after aortopulmonary window repair. Surgical repair of aortopulmonary window, even when associated with other cardiac anomalies, carries a low risk. Early surgical treatment achieved excellent immediate and long-term results.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.