title: Medium-term outcome of anatomically repaired congenitally corrected transposition: the double switch operation.
abstract: BACKGROUND
  The double switch operation is emerging as the procedure of choice for congenitally corrected transposition of the great arteries. However, rhythm disturbances in the postoperative period are rarely discussed.
  
  
  RESULTS
  Eighteen survivors who underwent corrective surgery for congenitally corrected transposition of the great arteries were followed up. Patients in group I (n=8), who also had a ventricular septal defect and pulmonary stenosis, had undergone the Senning plus Rastelli operation. Patients in group II (n=10), who did not have pulmonary stenosis, had undergone the Senning and arterial switch operation. The patients were followed up by periodical clinical examination, echocardiography and 24-hour Holter monitoring. In group I, follow-up ranged from 24 to 66 months (mean 44 months). There was no late death and all the patients are symptom free. There was no significant atrioventricular valve regurgitation and left ventricular function was normal. There were no rhythm disturbances. In group II, follow-up ranged from 2 to 72 months (mean 48 months). There were 2 late deaths due to atrial tachyarrhythmia and residual pulmonary hypertension 36 and 8 months after the procedure, respectively. One patient had significant mitral regurgitation and required mitral valve replacement. Three patients had recurrent atrial/junctional tachyarrhythmia: one of them was lost to follow-up after 1 year while another died of resistant atrial tachyarrhythmia. The third patient underwent mitral valve replacement for severe mitral regurgitation and developed complete heart block necessitating a permanent pacemaker implantation.
  
  
  CONCLUSIONS
  Though good long-term results are obtained following the double switch operation, the problem of atrial arrhythmias still needs to be addressed suitably.
authors.affiliation: Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi. rsharmacvs@hotmail.com
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sharma
authors.forename: Shiv K
authors.initials: SK
authors.lastname: Choudhary
authors.forename: Rajnish
authors.initials: R
authors.lastname: Juneja
authors.forename: Anil
authors.initials: A
authors.lastname: Bhan
authors.forename: Shyam S
authors.initials: SS
authors.lastname: Kothari
authors.forename: Anita
authors.initials: A
authors.lastname: Saxena
authors.forename: Panangipalli
authors.initials: P
authors.lastname: Venugopal
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D013612:Tachycardia, Ectopic Atrial / Q000209:etiology / Q000517:prevention & control; D014188:Transposition of Great Vessels / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects