[Surgical strategy for transposition of the great arteries with intact ventricular septum after the neonatal period].
OBJECTIVE
To assess the surgical results in patients with transposition of the great arteries and intact ventricular septum undergoing surgery after the neonatal period.


METHODS
From January 1998 to March 2004, 121 children with transposition of the great arteries with intact ventricular septum were treated, 29 (24%) of whom after the neonatal period. Selection for surgical treatment was based on echocardiographic assessment by use of the calculation of left ventricular mass and configuration of the ventricular septum. Of the 29 children, 12 were selected for primary anatomic correction, 12 for 2-stage correction after surgical preparation of the left ventricle, and 5 underwent atrial correction.


RESULTS
In the group undergoing primary anatomic correction, one (8.3%) patient died at the hospital due to sepsis. In the group undergoing 2-stage correction, 5 patients underwent slow preparation with correction 3-6 months after the first stage, 4 of whom died after the first stage. This fact caused a change in our protocol, with adoption of the rapid preparation technique in the other 7 patients, of whom all achieved the second stage. Of the 8 children undergoing the second stage, one died at the hospital and another died later. Late clinical evolution of the children in both groups is excellent.


CONCLUSIONS
The echocardiographic selection allowed a safe choice of the best surgical approach for patients with transposition of the great arteries and intact ventricular septum after the neonatal period.
Gontijo Filho
Bayard
B
Biocor Instituto, Belo Horizonte, MG. bgontijo@cardiol.br
Fantini
Fernando A
FA
Martins
Cristiane
C
Lopes
Roberto Max
RM
Pereira
Roberto de S Thiago
Rde S
Rabelo
Sonia Maria
SM
Heyden
Eliana
E
Vrandecic
Erika
E
Vrandecic
Mario O
MO
D004452:Echocardiography; D005260:Female; D006346:Heart Septum / Q000601:surgery; D006352:Heart Ventricles; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D012086:Reoperation; D015996:Survival Rate; D014188:Transposition of Great Vessels / Q000150:complications / Q000401:mortality / Q000601:surgery*; D014694:Ventricular Outflow Obstruction / Q000150:complications