Intermediate results of the arterial switch repair

Norwood, William I.; Dobell, Anthony R.C.; Freed, Michael D.; Kirklin, John W.; Blackstone, Eugene H.

doi:10.1016/s0022-5223(19)35153-0

Cited by 169 publications

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“…7 Conversely, the incidence of unusual coronary patterns was similar to that seen in the literature, with 69% of patients having type A and 9% having a single coronary artery (Figure 3). 2,14,21 Most procedures were performed without deep hypothermic circulatory arrest, which was used in 37% of the patients. Because the duration of deep hypothermic circulatory arrest was variable, its use (for more than a few minutes to close the atrial septal defect) appears limited to cases with aortic arch pathology, yet did not appear to influence outcome (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…A fter its introduction by Jatene and colleagues 1 in the early 1980s, as techniques in myocardial preservation improved and experience in coronary and congenital cardiac surgery accumulated, the arterial switch operation (ASO) evolved into the primary modality for treating transposition of the great arteries (TGA), by and large replacing the Mustard and Senning operations. [2][3][4] More recently, excellent results of the ASO have been reported from individual centers or collaborate studies. [5][6][7][8] Operative mortality for simple TGA is reported in the range of 2% to 7%, an impressive improvement compared with the mortality of approximately 15% found in earlier studies.…”

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confidence: 99%

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The arterial switch operation in Europe for transposition of the great arteries: A multi-institutional study from the European Congenital Heart Surgeons Association

Sarris

Chatzis

Giannopoulos

et al. 2006

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The arterial switch operation in Europe for transposition of the great arteries: A multi-institutional study from the European Congenital Heart Surgeons Association

Sarris

Chatzis

Giannopoulos

et al. 2006

The Journal of Thoracic and Cardiovascular Surgery

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“…Un avance importante fue la incorporación de esta operación al período neonatal, demostrándose que el ventrículo izquierdo era capaz de adaptarse a la mayor post-carga luego del switch arterial dentro de las primeras semanas de vida, en que existe la posibilidad de desarrollar hiperplasia miocárdica 14 . Es así como desde la década del 80 se consolidó el concepto de reparar esta cardiopatía mediante switch arterial en el período neonatal 15 . De esta forma, esta operación se transformó en un ícono de la cirugía cardíaca compleja en recién nacidos y de alguna manera se constituyó en un indicador de la calidad de los distintos grupos cardioquirúrgicos en el mundo 16 .…”

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Resultados Inmediatos Y Alejados Del Switch Arterial en Pacientes Con Dextrotransposición De Grandes Arterias: Experiencia De 20 Años

et al. 2013

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Objetivos: Comunicar los resultados de la operación de switch arterial en pacientes portadores de dextro Transposición de Grandes Arterias (D-TGA) y evaluar su evolución en el tiempo. Pacientes y Método: Estudio retrospectivode pacientes sometidos a switch arterial entre mayo de 1992 y noviembre de 2012. Se comparó período 1 (1992 a 2002) con período 2 (2003 a 2012). Se definió D-TGA simple aquella sin lesiones asociadas y D-TGA compleja aquella con asociación de comunicación interventricular o coartación aórtica.Resultados: Un total de 108 pacientes componen la serie, 44 en el período 1 y 64 en el período 2, sin diferencias demográficas y anatómicas entre ambos períodos. Setenta tenían D-TGA simple y 38 D-TGA compleja. La mortalidad operatoria en el período 1 fue 33% versus 8,4% en el período 2 (p< 0.025); hubo tendencia a mayor mortalidad en pacientes con anatomía coronaria compleja. Se observó una disminución del riesgo relativo de mortalidad de 68,7% en el período 2. El 28,7% presentaron complicaciones postoperatorias, sin diferencias entre ambos períodos. Un paciente falleció en forma alejada. La mediana de seguimiento fue de 60 meses y la supervivencia de 84,25% a 10 y 20 años. Se realizaron 16 re intervenciones, principalmente plastías percutáneas de ramas pulmonares. La mayoría de los pacientes se mantenían asintomáticos. La mortalidad operatoria de los últimos 5 años fue 2,6%. Conclusiones:La mortalidad operatoria ha disminuido significativamente a lo largo de 20 años; persiste un mayor riesgo en ciertos patrones de anatomía coronaria. La supervivencia alejada y libre de reintervenciones es muy favorable. 205Resultados inmediatos y alejados del switch arterial en pacientes con dextrotransposición... Becker P., et al.Aim: to report the results of the arterial Switch operation in patients with D-transposition of the great vessels (D-TGA) and to evaluate their late course.

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“…The operation itself and the low incidence of late complications are well documented and do not require further discussion. 4,5,12,[16][17][18][19] Owing to the typically close relationship of the ventricular septal defect to the cardiac valves and the manipulation there during closure, one could expect an increased valvar dysfunction in patients with transposition of the great arteries/ventricular septal defect after repair in comparison to patients without a ventricular septal defect. Losay et al 9 analysed the follow-up data of 1156 patients with transposition of the great arteries after arterial switch operation and showed an increased risk of neo-aortic valve regurgitation in patients with a ventricular septal defect.…”

Section: Commentmentioning

confidence: 99%

Is the function of all cardiac valves after the arterial switch operation influenced by an associated ventricular septal defect?

et al. 2011

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A ventricular septal defect in transposition of the great arteries is frequently closely related to the cardiac valves. The valvar function after arterial switch operation of patients with transposition of the great arteries and ventricular septal defect or intact ventricular septum was compared. We analysed the function of all cardiac valves in patients who underwent the arterial switch operations pre- and post-operatively, 1 year after the procedure and on follow-up. The study included 92 patients - 64 with transposition of the great arteries/intact ventricular septum and 28 with transposition of the great arteries/ventricular septal defect. The median age at surgery was 5.5 days in transposition of the great arteries/intact ventricular septum (0-73 days) and 7.0 days in transposition of the great arteries/ventricular septal defect (4-41 days). Follow-up was 51.7 months in transposition of the great arteries/intact ventricular septum (3.3-177.3 months) and 55 months in transposition of the great arteries/ventricular septal defect (14.6-164.7 months). Neo-aortic, neo-pulmonary, and mitral valvar function did not differ. Tricuspid regurgitation was more frequent 1 year post-operatively in transposition of the great arteries/ventricular septal defect (n = 4) than in transposition of the great arteries/intact ventricular septum. The prevalence of neo-aortic regurgitation and pulmonary stenosis increased over time, especially in patients with transposition of the great arteries/intact ventricular septum. The presence of a ventricular septal defect in patients undergoing arterial switch operation for transposition of the great arteries only has a minor bearing for the development of valvar dysfunction on the longer follow-up.

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Intermediate results of the arterial switch repair

Cited by 169 publications

References 8 publications

The arterial switch operation in Europe for transposition of the great arteries: A multi-institutional study from the European Congenital Heart Surgeons Association

The arterial switch operation in Europe for transposition of the great arteries: A multi-institutional study from the European Congenital Heart Surgeons Association

Resultados Inmediatos Y Alejados Del Switch Arterial en Pacientes Con Dextrotransposición De Grandes Arterias: Experiencia De 20 Años

Is the function of all cardiac valves after the arterial switch operation influenced by an associated ventricular septal defect?

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