- 作者：Mar铆a Jos茅 Rodr铆guez Puras ; Luisa Cabeza-Letr谩n ; Manuela Romero-Vazquianez ; Jos茅 Santos de Soto ; Reza Hosseinpour ; Mauro Gil Fournier ; Antonio Alvarez Madrid ; Antonio Gonz谩lez ; Pilar P茅rez ; Pastora Gallego
- 关键词：CIV ; comunicació ; n interventricular ; IAo ; insuficiencia aó ; rtica ; TCGA ; transposició ; n completa de grandes arterias
- 刊名：Revista Espa?ola de Cardiología
- 出版年：March, 2014
- 年：2014
- 卷：67
- 期：3
- 页码：181-188
- 全文大小：404 K
Introduction and objectives
The arterial switch operation is currently the preferred surgical approach for complete transposition of the great arteries. We sought to determine the mid-term results of this intervention.
Methods
A single-institution retrospective review of clinical records of all consecutive patients who underwent the arterial switch surgery between 1985 and 2010.
Results
Overall, the operation was performed on 155 patients (68% boys) at a median age of 13 days: 64% with an intact septum, 46% with a ventricular septal defect, and 4.5% with associated aortic arch anomaly. The usual coronary pattern was found in 63%. Palliative surgery was performed prior to arterial switch in 6.5%. In all, 137 perioperative survivors were followed for a median of 6 years. Late mortality was 2.9%, of which 50% was due to coronary complications. Eighteen percent required surgical and/or percutaneous reintervention: 95.6% for right-sided obstruction and 4.3% for aortic regurgitation. At last follow-up, 92% had functional class I symptoms and 95% were free of arrhythmias. The left ventricular ejection fraction was greater than 55% in 95%, 28% had neoaortic regurgitation (78% mild regurgitation), and 31% had right ventricular outflow tract obstruction with a mean gradient according to echocardiography greater than 25 mmHg.
Conclusions
Mid-term survival of patients after arterial switch operation is excellent and their functional status is good. However, a few patients have residual lesions and a need for further intervention during follow-up, mostly for right-sided obstructions. Late mortality was uncommon and was related to coronary complications. Neoaortic root dilation and regurgitation are not major issues in early adulthood, but the long-term course of these lesions is still unknown.
Full English text available from: