[Indications for the surgical correction of patients with transposition of the great arteries associated with an interventricular defect. Analysis of 98 cases operated on using the Mustard technic].
At the Hospital for Sick Children, London, between Jan. 1965 and Jan. 1980, 98 patients, ranging in age from 22 days to 20.8 years (mean = 29.6 months), with a clinical diagnosis of transposition of the great arteries (TGA) associated with a ventricular septal defect (VSD) found at cardiac catheterization, underwent Mustard procedure at the atrial level, whether or not associated with the VSD closure. Twenty-nine other patients, with irreversible obstructive pulmonary vascular disease in whom a "palliative" Mustard was performed, have been excluded from this report. At operation, in 8 cases, the VSD was found to have closed spontaneously during the interval between the cardiac catheterization and the surgical repair, while, in 13 patients, the VSD was judged to be too small to influence the hemodynamic results and, accordingly, was left open. In 35 cases the VSD was closed with mattress stitches buttressed with dacron pledgets and in 42 patients a dacron patch was used. The defects were accessible through the tricuspid valve in all but 10 cases. There were 24 early deaths (24%) and these did not correlate either with the year of operation or with the age at the time of operation. The mortality rate was higher in the cases who had required previous pulmonary artery banding (37%), than in those who had not (21.5%), but this difference was not statistically significant. The early results were related to the size of the VSD. In the 21 patients in whom the VSD was partially or completely closed, the early mortality was 9.5%.(ABSTRACT TRUNCATED AT 250 WORDS)
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008722:Methods; D011183:Postoperative Complications / Q000401:mortality; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery*
Indicazioni alla correzione chirurgica nei pazienti con trasposizione delle grandi arterie associata a difetto interventricolare. Analisi di 98 casi operati secondo la tecnica di Mustard.