[Primary, single-stage arterial switch operations at a newly-established, comprehensive congenital cardiac center performed in the neonatal age and beyond]

Orv Hetil. 2015 Jun 21;156(25):1014-9. doi: 10.1556/650.2015.30176.
[Article in Hungarian]

Abstract

Introduction: Outcome of arterial switch operation for transposition of the great arteries with/without ventricular septal defect is a service key-performance-indicator.

Aim: The aim of the authors was to assess patient characteristics and parameters in the perioperative course.

Method: In the setting of a newly-established, comprehensive tertiary-care center, primary complete repair was performed including associated anomalies, e.g. transverse arch repairs. Patients with d-transposition were grouped according to coexistence of ventricular septal defect.

Results: 118 arterial switch operations were performed between 2007 and 2014 with 96.62% survival (114/118). Ventricular septal defect and repair of associated anomalies did not yield worse outcome. Left ventricular re-training with late presentation necessitated mechanical circulatory support for 4.5±1.5 days.

Conclusions: D-transposition is suitable for standardization of clinical algorithm and surgical technique. Quality standards contribute to excellent outcomes, minimize complications, and serve as blueprint for other neonatal open-heart procedures. Availability of mechanical circulatory support is key for single-stage left ventricular re-training beyond the neonatal period.

Keywords: infant; kimenetel; komplett nagyér-transzpozíció; newborn; postoperative complications/mortality; posztoperatív szövődmények/mortalitás; transposition of great vessels/surgery; treatment outcome; újszülött/csecsemő.

Publication types

  • English Abstract

MeSH terms

  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods*
  • Cardiac Surgical Procedures / mortality
  • Cardiac Surgical Procedures / standards
  • Cardiac Surgical Procedures / statistics & numerical data*
  • Extracorporeal Circulation
  • Extracorporeal Membrane Oxygenation
  • Female
  • Heart Arrest, Induced
  • Heart Septal Defects, Ventricular / complications
  • Heart Septal Defects, Ventricular / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Perioperative Period
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers
  • Transposition of Great Vessels / complications
  • Transposition of Great Vessels / surgery*
  • Treatment Outcome
  • United Arab Emirates