title: [The individualized surgical treatment of transposition of the great arteries].
abstract: OBJECTIVE
  To discuss the effectiveness of individualized strategy of surgical management on the great arteries (TGA).
  
  
  METHODS
  From March 1998 to October 2009, 127 cases (97 males and 30 females) with TGA were treated. There were 97 male and 30 female, aged from 4 hours old to 17 years old with a mean of (25 ± 37) months, weighted from 2.7 to 47.5 kg with a mean of (8 ± 8) kg. The palliative operations included Glenn operation in 14 cases (3 cases double Glenn procedure), Balalock-Taussing shunt in 14 cases, Banding operation in 8 cases, and atrial septal defect enlarge/Banding/Balalock-Taussing shunt in 15 cases. The end-stage operation included Senning procedure in 5 cases, Switch procedure in 32 cases, 2(nd)-stage Switch procedure in 11 cases, Switch procedure with VSD repairing in 20 cases, Switch procedure with Hybrid in 1 case, Nikaidoh procedure in 3 cases, Rastelli procedure in 13 cases, Fonton procedure in 18 cases, other procedure in 4 cases. Twenty-one cases underwent 2 operations, and 5 cases underwent 3 or more operations. Sixty-six cases underwent delayed sternal closure.
  
  
  RESULTS
  There were 12 cases of death operatively in 127 cases. The total operative mortality was 9.4%. There were 5 cases dying of low cardiac output during the operation, 2 of pulmonary hypertension crisis, 2 of hemorrhage, 1 of grafting problem of coronary artery deformation, 1 of renal failure after Fonton procedure and 1 case of newborn dying of spontaneous rupture of liver post-operatively. The patients were followed up for 1 month to 12 years. There were 10 patients with vary degrees complications such as pulmonary stenosis, residual shunt and narrow channel. Three cases underwent reoperation. The rest of survived cases had normal heart function, good growth and development state.
  
  
  CONCLUSIONS
  Individualized strategy of surgical management based on anatomical conditions of TGA can significantly improve the success rate of surgery and long-term survival.
authors.affiliation: Department of Cardiothoracic Surgery, Nanjing Children's Hospital, Nanjing Medical University, Nanjing 210008, China. mohsuming15@sina.com
authors.forename: Xu-ming
authors.initials: XM
authors.lastname: Mo
authors.forename: Hai-tao
authors.initials: HT
authors.lastname: Gu
authors.forename: Wei-song
authors.initials: WS
authors.lastname: Zuo
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Wei
authors.initials: W
authors.lastname: Peng
authors.forename: Ji-rong
authors.initials: JR
authors.lastname: Qi
authors.forename: Li
authors.initials: L
authors.lastname: Shen
authors.forename: Jin-yang
authors.initials: JY
authors.lastname: Ding
authors.forename: Jian-hai
authors.initials: JH
authors.lastname: Xia
authors.forename: Zhen-xi
authors.initials: ZX
authors.lastname: Wang
authors.forename: Long-bao
authors.initials: LB
authors.lastname: Qian
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014188:Transposition of Great Vessels / Q000601:surgery*; D016896:Treatment Outcome