Surgical treatment of transposition of the great arteries.
BACKGROUND
With regard to risk of the failure of systemic right ventricle after physiological correction of transposition of great arteries, anatomic repair is a current method of choice.


OBJECTIVE
Analysis of results of surgical correction of transposition of great arteries performed between 1992 and October 1998.


METHODS
A total of 111 patients were operated on for transposition of the great arteries. In the 1st group of patients (n = 21, mean age was 135 +/- 55 days), physiological correction according to Senning was performed. Patients of the 2nd group (n = 90, mean age was 15.4 +/- 21.6 days) underwent anatomic repair.


RESULTS
Early mortality was 6% (7 patients). Mean follow-up is 2.95 years (1.9 SD) ranging from 0.2 years to 6.1 years. Actuarial 1-month survival in the whole cohort (n = 111) is 94%, and it remains unchanged at 1, 2, 3, 4, 5, and 6 years of follow-up. Patients, who underwent surgery after 1997, show significantly better survival compared to those operated before 1997 (p = 0.0997). Thus, a date of operation (before 1997) is the only significant risk factor for death. Survival in patients operated after 1997 (n = 40) is 98%. All patients belonging to the 2nd group are in functional group NYHA 1.


CONCLUSIONS
Anatomic repair of transposition of the great arteries is a method of choice for treatment of this congenital heart defect. Left ventricle becomes systemic ventricle, which is essential in view of long-term performance. Psychomotor development of children, who underwent ASO, is comparable with that of healthy population. (Tab. 3, Fig. 3, Ref. 18.)
Hraska
V
V
Department of Cardiovascular Surgery, Children's University Hospital, Bratislava, Slovakia. hraska@dkcba.sk
Sojak
V
V
Kostolny
M
M
Nosal
M
M
Sagat
M
M
Petko
M
M
Kantorova
A
A
Nagi
A
A
Kaldararova
M
M
Siman
J
J
D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015996:Survival Rate; D014188:Transposition of Great Vessels / Q000401:mortality / Q000601:surgery*