[Two-stage repair of the transposition of great arteries with interruption/coarctation of the aorta]

Kyobu Geka. 2005 Jan;58(1):66-70.
[Article in Japanese]

Abstract

We report on 10 patients who underwent two-stage repair of transposition of the great arteries (TGA) with interruption (IAA) or coarctation (CoA) of the aorta. First, an operation for aortic arch reconstruction was performed: Blalock-Park with pulmonary artery banding (PAB) for IAA (5 patients), subclavian flap with PAB for CoA (4 patients) and end-to-end anastomosis without PAB (1 patient). All survived the first operation and had no significant pressure gradient with good growth of the ascending aorta, except for the 1 case without PAB. Half of the 8 patients who underwent PAB developed migration of the PAB. The arterial switch operation (ASO) was performed 0.7-12.6 (5.6+/-4.7) months after the first surgery. One patient with an abnormal coronary artery tract was lost after ASO. Five developed pulmonary artery stenosis and 1 developed supra-aortic stenosis late after ASO. Two patients need reoperation, 1 for supra-aortic stenosis, and the other for reCoA. Two-stage repair for TGA with IAA/CoA is still a useful method with a good operative result. However, strict follow-up is necessary because of the high frequency of late morbidity.

Publication types

  • English Abstract

MeSH terms

  • Aorta, Thoracic / abnormalities*
  • Aorta, Thoracic / surgery
  • Aortic Coarctation / complications
  • Aortic Coarctation / surgery*
  • Cardiac Surgical Procedures / methods*
  • Double Outlet Right Ventricle / complications
  • Double Outlet Right Ventricle / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Transposition of Great Vessels / complications
  • Transposition of Great Vessels / surgery*