[Surgical treatment of transposition of the great arteries in infancy (author's transl)].
Since 85 to 90% of children with d-TGA die in the first year of life, treatment of this malformation is mandatory before age one. Even after Rashkind septostomy, 50% of the patients die before 2,5 years of age. In Great Ormond Street Hospital for Sick Children all the patients with d-TGA have a balloon septostomy performed at birth. Then at 4-5 months of age all patients are evaluated with cardiac catheterisation and angiography. If the patient is doing well, surgery at atrial level (Mustard or Senning operation) is performed between 6 and 12 months of age. But, if despite Rashkind atrioseptostomy, the child remains cyanotic the authors do not perform Blalock Hanlon operation and prefer to do a repair at atrial level. If the child presents with d-TGA and PDA the ductus is ligated during the neonatal period and the repair at atrial level is performed before 6 months of age. In children with VSD associated with d-TGA, the authors prefer to do a Mustard or a Senning operation with closure of the VSD, and so before 6 months of age. In patients with left ventricular outflow tract obstruction, the authors do a Blalock Taussig shunt in the cases with VSD and try a repair at atrial level in the cases with intact septum. The authors discuss the results, not only in term of mortality but also in terms of post-operative complications.
D000367:Age Factors; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D008722:Methods; D014188:Transposition of Great Vessels / Q000150:complications / Q000401:mortality / Q000601:surgery*
Traitement chirurgical de la transposition des gros vaisseaux chez le nourrisson.