[Arterial-switch operation for transposition of the great vessels; good results in the Wilhelmina Children's Hospital, Utrecht, 1977-2000].
OBJECTIVE
To examine the results of the arterial switch operation which is used to correct the transposition of the great arteries.


METHODS
Descriptive.


METHODS
In the period May 1977-October 2000 195 patients at the Wilhelmina Children's Hospital in Utrecht, the Netherlands, underwent an arterial switch operation. The patient group consisted of 132 boys and 63 girls, with a median age at surgery of 8 days (range: 0-1976). In accordance with the protocol, the postoperative follow-up consisted of echocardiography and an ECG. Further investigations were performed on indication. Additional data were collected from the status reports. The mean follow-up was 8.0 years (range: 0.04-22.17).


RESULTS
The overall peri-operative mortality was 15% (30/195). Initially this figure was about 50%, in the 1980s it was 15% and from 1996 onwards it was 4%. Of the 151 surviving and traceable patients, 2 patients died years later (1.3%). Of the remaining 149 patients, 145 were classified in New York Heart Association class I and 4 in class II. Due to pulmonary stenosis, 45 reinterventions were required in 26 patients (/149; 17%). Left ventricle dysfunction occurred in 5 patients (3%), arrhythmias in 5 patients and aorta abnormalities in 5 patients. Coronary artery abnormalities were found in 5 of the 61 patients who underwent angiography (8%).


CONCLUSIONS
Peri-operative mortality decreased to 4% and late mortality was 1.3%. The long-term clinical outcome of the arterial switch operation was good. Morbidity was predominantly caused by pulmonary stenosis and late coronary obstruction.
Hutter
P A
PA
Universitair Medisch Centrum/Wilhelmina Kinderziekenhuis, Kinderhartcentrum, Postbus 85.090, 3508 AB Utrecht. p.hutter@wkz.azu.nl
Chung
W Y
WY
Nunumete
D C
DC
Hitchcock
J F
JF
Bennink
G B
GB
Meijboom
E J
EJ
D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D023921:Coronary Stenosis / Q000209:etiology; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011666:Pulmonary Valve Stenosis / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014188:Transposition of Great Vessels / Q000401:mortality / Q000473:pathology / Q000601:surgery*