title: Late outcome after arterial switch operation for complete transposition of great arteries with left ventricular outflow tract obstruction.
abstract: BACKGROUND
  Long-term follow-up of patients who underwent arterial switch operation for complete transposition of great arteries with anatomic left ventricular outflow tract obstruction (LVOTO) has rarely been brought into the focus.
  
  
  METHODS
  Of 299 patients who underwent an arterial switch operation between January 1991 and January 2001, 23 patients had anatomic LVOTO. Age ranged from 4 days to 18 years (median 90 days) and weight ranged from 2.6 to 35 kg (median 4.3 kg). Surgical management included arterial switch operation, closure of ventricular septal defect wherever indicated, and excision of LVOTO.
  
  
  RESULTS
  Among patients with preoperative LVOTO there were 2 early deaths and 8 patients had mild neoaortic regurgitation at the time of discharge. Follow-up ranged from 8 months to 9 years (mean 60 +/- 12 months). In 4 patients who had mild neoaortic regurgitation at discharge, the regurgitation progressed to moderate or severe degree after a follow-up of 22 to 72 months. In 1 patient mild mitral regurgitation present at the time of discharge progressed to severe mitral regurgitation. This patient subsequently underwent double valve replacement.
  
  
  CONCLUSIONS
  Presence of preoperative anatomical LVOTO in patients undergoing arterial switch operation predicts high incidence of postoperative neoaortic regurgitation.
authors.affiliation: Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India. rsharmacvs@hotmail.com
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sharma
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Choudhary
authors.forename: Anil
authors.initials: A
authors.lastname: Bhan
authors.forename: R Pradeep
authors.initials: RP
authors.lastname: Kumar
authors.forename: Rajnish
authors.initials: R
authors.lastname: Juneja
authors.forename: Shyam Sunder
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; D001022:Aortic Valve Insufficiency / Q000209:etiology; D013504:Cardiovascular Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology; D011183:Postoperative Complications; D014188:Transposition of Great Vessels / Q000601:surgery*; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000601:surgery*