[Two-stage repair of the transposition of great arteries with interruption/coarctation of the aorta].
We report on 10 patients who underwent two-stage repair of transposition of the great arteries (TGA) with interruption (IAA) or coarctation (CoA) of the aorta. First, an operation for aortic arch reconstruction was performed: Blalock-Park with pulmonary artery banding (PAB) for IAA (5 patients), subclavian flap with PAB for CoA (4 patients) and end-to-end anastomosis without PAB (1 patient). All survived the first operation and had no significant pressure gradient with good growth of the ascending aorta, except for the 1 case without PAB. Half of the 8 patients who underwent PAB developed migration of the PAB. The arterial switch operation (ASO) was performed 0.7-12.6 (5.6+/-4.7) months after the first surgery. One patient with an abnormal coronary artery tract was lost after ASO. Five developed pulmonary artery stenosis and 1 developed supra-aortic stenosis late after ASO. Two patients need reoperation, 1 for supra-aortic stenosis, and the other for reCoA. Two-stage repair for TGA with IAA/CoA is still a useful method with a good operative result. However, strict follow-up is necessary because of the high frequency of late morbidity.
Fukumura
Fumio
F
Department of Cardiovascular Surgery, Kyushu Koseinenkin Hospital, Kitakyushu, Japan.
Sese
A
A
Ueno
Y
Y
Imoto
Y
Y
Sakamoto
M
M
Ochiai
Y
Y
Iwai
T
T
Joho
K
K
D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery; D001017:Aortic Coarctation / Q000150:complications / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004310:Double Outlet Right Ventricle / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery*