Total correction of transposition of the great arteries. Conduction disturbances in infants younger than three months of age.
Although total physiological correction of d-transposition of the great arteries (d-TGA) is technically feasible in infants, the optimal age for correction has remained controversial because of concern regarding major life-threatening arrhythmias and the long-term results of the intra-atrial baffle procedure. During a 3 year period, 54 children aged 4 days to 5 years, including 24 infants aged 3 months or younger, underwent the baffle procedure. Thirty-two children had simple transposition and underwent only placement of a pericardial baffle; no deaths occurred in this group. Twenty-two had complex transposition requiring in addition closure of a ventricular septal defect (VSD) and/or resection of outflow tract obstruction; there were four hospital and two late deaths in this group. A single operative approach was used in all patients. Sinus rhythm was present at discharge in 85 percent of the infants and 76 percent of the older children. Three factors--age, mode of cardiopulmonary support, and complexity of the lesion--influenced these results.
D000367:Age Factors; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D001282:Atrial Flutter / Q000209:etiology; D002404:Catheterization; D002675:Child, Preschool; D004562:Electrocardiography; D006325:Heart Atria / Q000601:surgery; D006327:Heart Block / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008722:Methods; D010496:Pericardium / Q000637:transplantation; D011183:Postoperative Complications; D014182:Transplantation, Autologous; D014188:Transposition of Great Vessels / Q000401:mortality / Q000601:surgery*