Late re-interventions following arterial switch operations in transposition of the great arteries. Incidence and surgical treatment of postoperative pulmonary stenosis.
Seventy-six patients were studied after arterial switch operation (ASO) between May 1977 and February 1992. Pulmonary artery reconstruction was initially performed by: conduit interposition in 5 patients, direct main pulmonary artery anastomosis and button patches in 60 patients, and pantaloon-like patch repair in 11 patients. Pulmonary stenosis developed in 17 patients (22%), requiring a total of 26 late re-interventions. Re-intervention was required in four out of five patients operated with pulmonary artery conduits, 11 out of 60 with a button patch repair and 2 out of 11 following pantaloon-type repair. In this series pulmonary artery stenosis (PS) involving the pulmonary valve occurred in 9/17 patients. Involvement of the pulmonary valve was related to the technique of pulmonary artery reconstruction. In these patients surgery is necessary. Balloon angioplasty can be a valuable tool when the stenosis is more distal. The incidence of PS was not influenced by the type of reconstruction or the use of Lecompte's maneuver.
Spiegelenberg
S R
SR
Pediatric Heart Centre, Wilhelmina Children's Hospital, University Hospital Utrecht, The Netherlands.
Hutter
P A
PA
van de Wal
H J
HJ
Hitchcock
J F
JF
Meijboom
E J
EJ
Harinck
E
E
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D000800:Angioplasty, Balloon; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D010496:Pericardium / Q000637:transplantation*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D011651:Pulmonary Artery / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000209:etiology / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D012086:Reoperation; D015996:Survival Rate; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery*