2Başkent Üniversitesi Tıp Fakültesi, İstanbul Sağlık Uygulama ve Araştırma Merkezi, Pediyatrik Kardiyoloji ve Anabilim Dalı, Altunizade, İstanbul-Türkiye
3Başkent Üniversitesi Tıp Fakültesi, İstanbul Sağlık Uygulama ve Araştırma Merkezi. Kalp ve Damar Cerrahisi Anabilim Dalı, Altunizade, İstanbul-Türkiye
4Department of Pediatric Cardiology Faculty of Medicine, University of Başkent, İstanbul-Turkey
5Başkent Üniversitesi Tıp Fakültesi, İstanbul Sağlık Uygulama ve Araştırma Merkezi, Pediyatrik Kardiyoloji ve Anabilim Dalı, Altunizade, İstanbul-Türkiye
6Department of Pediatric Cardiology, Adana Teaching and Medical Research Center, Başkent University, Adana-Turkey
7Başkent Üniversitesi Tıp Fakültesi, İstanbul Sağlık Uygulama ve Araştırma Merkezi. Kalp ve Damar Cerrahisi Anabilim Dalı, Altunizade, İstanbul-Türkiye
8Department of Cardiovascular Surgery, Faculty of Medicine, Başkent University, Ankara-Turkey
9Başkent Üniversitesi Tıp Fakültesi, İstanbul Sağlık Uygulama ve Araştırma Merkezi. Kalp ve Damar Cerrahisi Anabilim Dalı, Altunizade, İstanbul-Türkiye
10Department of Cardiovascular Surgery, Faculty of Medicine, Gülhane Military Medical Academy, Ankara, Turkey
Abstract
Objective: 1. Follow-up data of patients with simple transposition of great arteries (TGA) and TGA with ventricular septal defect (VSD), who had arterial switch operation (ASO) are compared. 2. Factors affecting mortality and morbidity after ASO are described. Methods: Seventy-six patients, who had an ASO between April 2007 and August 2010 were studied retrospectively. The patients with intact ventricular septum (IVS) (n=36) were in Group1, and those with VSD (n=40) in Group 2. The pre and postoperative clinical and echocardiographic variables and intensive care unit (ICU) outcomes were compared among groups using Mann-Whitney U, Pearson correlation and logistic regression tests. Results: The mean age at operation was 44.1 days, weight was 3.6±0.98 kg. Patients were followed for 15.5±11.21 months. The aortic cross-clamp (AoCC) and cardiopulmonary bypass (CPB) times were higher in patients with VSD (p=0.001, p=0.004). Patients in Group 1 had longer inotropic agent infusion (p=0.001). Length of stay in ICU was similar in two groups (p>0.05). There was no correlation between the length of stay in ICU and age, weight, CPB time, AoCC time. Aortic regurgitation was more frequent in Group 2 (p=0.02). During follow-up, 12 patients died (15.7%), and 8 patients had a revision operation (10.5%) (diaphragmatic plication in 4, pulmonary artery reconstruction in 1, recoarctation operation in 3 patients). Mortality was similar in groups (p>0.05). Conclusion: Arterial switch operation provides anatomical correction in TGA. Appropriate timing and good perioperative planning facilitates low morbidity and mortality in patients with VSD as in patients with simple TGA.