The Anatolian Journal of Cardiology
Original Investigation

Follow-up of our patients with transposition of the great arteries and arterial switch operation; comparison of simple and complex transposition cases

1.

Başkent Üniversitesi Tıp Fakültesi, İstanbul Sağlık Uygulama ve Araştırma Merkezi, Pediyatrik Kardiyoloji ve Anabilim Dalı, Altunizade, İstanbul-Türkiye

2.

Başkent Üniversitesi Tıp Fakültesi, İstanbul Sağlık Uygulama ve Araştırma Merkezi. Kalp ve Damar Cerrahisi Anabilim Dalı, Altunizade, İstanbul-Türkiye

3.

Department of Pediatric Cardiology Faculty of Medicine, University of Başkent, İstanbul-Turkey

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Department of Pediatric Cardiology, Adana Teaching and Medical Research Center, Başkent University, Adana-Turkey

5.

Department of Cardiovascular Surgery, Faculty of Medicine, Başkent University, Ankara-Turkey

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Department of Cardiovascular Surgery, Faculty of Medicine, Gülhane Military Medical Academy, Ankara, Turkey

Anatol J Cardiol 2011; 11: 726-731
DOI: 10.5152/akd.2011.195
Read: 199 Downloads: 139 Published: 01 July 2021

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.

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ISSN 2149-2263 EISSN 2149-2271