Midterm results of arterial switch operation in older patients with severe pulmonary hypertension.
BACKGROUND
It is widely accepted that patients older than 6 months with dextrotransposition of the great arteries and nonrestrictive ventricular septal defect or Taussig-Bing anomaly and severe pulmonary hypertension usually are not candidates for an arterial switch operation or even repair. This study aimed to evaluate the midterm results of the arterial switch operation in these selected patients.


METHODS
The records of 86 patients older than 6 months with dextrotransposition of the great arteries and nonrestrictive ventricular septal defect or Taussig-Bing anomaly and severe pulmonary hypertension undergoing the arterial switch operation at our institution from 2000 to 2008 were reviewed retrospectively. Eighty survivors were followed.


RESULTS
There were 6 hospital deaths (7.0%, 95% confidence interval, 1.6% to 12.4%). From 2006 to 2008, 46 were operated without deaths occurring. The median duration of follow-up was 42 months. Two late deaths occurred. Latest follow-up data showed that 2.8% of survivors were in New York Heart Association class II and 97.2% in class I.


CONCLUSIONS
Midterm results of the arterial switch operation for patients older than 6 months with dextrotransposition of the great arteries and nonrestrictive ventricular septal defect or Taussig-Bing anomaly and severe pulmonary hypertension are excellent in the current era.
Liu
Ying-long
YL
Pediatric Cardiac Center, Cardiovascular Institute, and Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China. hjb010222@163.com
Hu
Sheng-shou
SS
Shen
Xiang-dong
XD
Li
Shou-jun
SJ
Wang
Xu
X
Yan
Jun
J
Wu
Xin
X
Huang
Jing-bin
JB
Kong
Bo
B
D000015:Abnormalities, Multiple / Q000601:surgery*; D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000601:surgery*; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods; D055815:Young Adult