Two-stage arterial switch operation: is late ever too late?
Results of the two-stage arterial switch operation in 49 patients with transposition of the great arteries, performed between January 1995 and September 2000, were reviewed retrospectively. Twenty-one patients had a ventricular septal defect. Anatomical correction was carried out 21.89 +/- 9.86 months after pulmonary artery banding, with or without a modified Blalock-Taussig shunt. Hospital mortality was 8% (4 patients). During follow-up of 30.12 +/- 14.38 months, there was 1 late death and 1 patient required reoperation for pseudoaneurysm of the ascending aorta. Actuarial survival and freedom from reoperation at 5 years were 90% and 97%, respectively. Late anatomic correction (> 6 months) after the preliminary procedure can be performed with an acceptable mortality and morbidity, but undue delay may lead to left ventricular dysfunction, arrhythmias, and new aortic valve regurgitation or subaortic stenosis.
Al Qethamy
Howaida O
HO
Department of Cardiac Surgery Prince Sultan Cardiac Centre Riyadh Military Hospital Riyadh, Saudi Arabia.
Aizaz
Khawar
K
Aboelnazar
Saber A R
SA
Hijab
Samina
S
Al Faraidi
Yahya
Y
D002675:Child, Preschool; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000401:mortality* / Q000601:surgery*