Excellent survival and low complication rate in medium-term follow-up after arterial switch operation for complete transposition.
OBJECTIVE
To determine medium-term outcome after arterial switch operation for complete transposition in a population-based cohort.


METHODS
Retrospective study of all 86 patients operated on at our institution from 1982 to 2000. Age at operation was 0-256 days (median 6 days); 28 (32%) had closure of a ventricular septal defect, 2 of whom had double outlet right ventricle. Additional surgery included coarctectomy in three, pulmonary artery banding in two and atrial septectomy in one patient.


RESULTS
Thirty-day operative mortality was 7/86 (8.1%), after 1988 mortality was only 3.8% and confined to patients with unusual coronary artery patterns. There was no late mortality; Kaplan-Meier survival was 91%. Five patients (6% of survivors) were reoperated for right ventricular outflow tract obstruction. At last follow-up, 86% were free from complications; three had neurological complications, two were on treatment for ventricular dysfunction and one had a pacemaker for postoperative atrioventricular block.


CONCLUSIONS
In this cohort of first-generation patients treated with arterial switch operation, medium-term survival is excellent and the rate of reoperation and sequelae is low.
Rehnström
Pia
P
Division of Cardiothoracic Surgery, Queen Silvia Children's Hospital, Gothenburg University, Sweden. pia.rehnstrom@orebroll.se
Gilljam
Thomas
T
Südow
Göran
G
Berggren
Håkan
H
D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000401:mortality* / Q000601:surgery*; D016896:Treatment Outcome