title: Long-term outcomes and social independence level after arterial switch operation.
abstract: OBJECTIVE
  Various issues regarding the long-term survivors of arterial switch operation (ASO) have been clarified according to the improvement of surgical mortality. We reviewed the long-term results and social independence level after ASO.
  
  
  METHODS
  Two hundred and four (204) patients who had undergone ASO more than 15 years ago were studied retrospectively. ASO was performed as a primary operation (group I, n=99) or as a secondary operation (group II, n=105). Lecompte procedure was performed in 197 patients, modified Aubert procedure in 5, and original Jatene procedure in 2.
  
  
  RESULTS
  There were 11 late deaths. Kaplan-Meier survival rate (not including operative deaths) was 94.9% at 10 years and 94.9% at 15 years in group I, and 96.9% at 10 years and 94.4% at 15 years in group II. Forty-eight reoperations were performed (aortic valve replacement in 6, aortic valvoplasty in 2, Konno procedure in 1, double valve replacement in 1, right ventricular outflow tract reconstruction in 35). The reoperation-free rate including late death was 82.2% at 10 years and 75.7% at 15 years in group I, and 88.2% at 10 years and 78.1% at 15 years in group II. One hundred and seventy-eight patients were classified as NYHA class I and 7 patients as class II. All the patients except those with mental disorder (1) or neurodevelopmental impairment (3) were attending school or working. There was no significant difference in left ventricular function between group I and II, both showing values within the normal range.
  
  
  CONCLUSIONS
  The long-term (>15 years) outcome of ASO survivors was satisfactory. Most patients showed excellent cardiac function and were socially independent.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamazaki
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Takahiko
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Ishihara
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Iwata
authors.forename: Goki
authors.initials: G
authors.lastname: Matsumura
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kurosawa
mesh_terms: D000293:Adolescent; D000328:Adult; D001017:Aortic Coarctation / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004522:Educational Status; D004651:Employment; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery*