title: Long-term prognosis of double-switch operation for congenitally corrected transposition of the great arteries.
abstract: OBJECTIVE
  Recently, the double-switch operation for congenitally corrected transposition of the great arteries has become the procedure of choice in our institute; however, the long-term follow-up is uncertain.
  
  
  METHODS
  From 1983 to 2010, 90 patients with congenitally corrected transposition of the great arteries underwent the double-switch operation, which comprised of an atrial switch plus intraventricular rerouting (with or without extracardiac conduits) in 72 patients (group I), and an atrial switch plus arterial switch in 18 patients (group II). The mean age at operation was 7.4 years old in group I vs. 4.3 years old in group II. The mean follow-up period was 12.9 years in group I vs. 10.9 years in group II. Hospital and late mortality, reoperation, arrhythmia and NYHA status were analysed retrospectively.
  
  
  RESULTS
  The Kaplan-Meier survival, including hospital and late mortality at 20 years, was similar (75.7% in group I vs. 83.3% in group II). The freedom from reoperation was 77.6% in group I (redo-Rastelli in five patients, subaortic stenosis resection in three, tricuspid valve replacement in one and mitral valve plasty in one) vs. 94.1% in group II (P < 0.05 vs. group I; aortic valve replacement in one). The freedom from arrhythmia was 57.1% in group I vs. 78.6% in group II (P < 0.05 vs. group I). The ratio of NYHA class I to II at outpatient clinic was similar (86% in group I vs. 86% in group II).
  
  
  CONCLUSIONS
  The long-term prognosis of the double-switch operation for congenitally corrected transposition of the great arteries was acceptable. In particular, an atrial switch plus arterial switch could be performed with low morbidity, and it should be considered as the optimal procedure.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. shiramat@hij.twmu.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hiramatsu
authors.forename: Goki
authors.initials: G
authors.lastname: Matsumura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Konuma
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kurosawa
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000714:Anastomosis, Surgical; D001011:Aorta / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D000080041:Congenitally Corrected Transposition of the Great Arteries; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D011651:Pulmonary Artery / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome