title: 20 years of arterial switch operation for simple TGA.
abstract: BACKGROUND
  Arterial switch operation became the golden treatment for simple transposition of the great arteries (sTGA). We describe our experience with the arterial switch operation regarding long-term outcome and the need for re-intervention. Nevertheless, supravalvular pulmonary stenosis (SPS) remains a concern in the long run. We assess the evolution of SPS over time and evaluate the effect of technical modifications on SPS during our experience.
  
  
  METHODS
  We performed a retrospective study on 133 patients operated with ASO for TGA between October 1991 and November 2009. Last report method was used. We reviewed our pediatric cardiology and cardiac surgery database to examine the echocardiographic data and electrocardiograms. A mean follow-up of 9.2 years (+/- 5.83 SD) was reached.
  
  
  RESULTS
  One (0.8%) patient deceased postoperatively due to cardiogenic shock. The overall actuarial freedom from reoperation (open and percutaneous) was 88.1%, 78.5% and 76.9% at 1, 5 and 10 years. SPS needed to be treated in 17 patients. Valve regurgitation at final investigation was maximal moderate in 5 patients for the aortic valve, 10 for pulmonary valve and 3 in tricuspid valve.
  
  
  CONCLUSIONS
  ASO shows excellent long-term results in sTGA with a very low morbidity and mortality and is therefore the procedure of choice. Re-intervention rate is determined by SPS. Since the extensive mobilization of the pulmonary arteries and the creation of a longer neo-pulmonary root, reduction in SPS was seen with no re-interventions in the second half of the group. To obtain a final comparison with the atrial switch operation, a longer Follow-up is necessary.
authors: H
authors: H
authors: De Praetere
authors: J
authors: J
authors: Vandesande
authors: F
authors: F
authors: Rega
authors: W
authors: W
authors: Daenen
authors: G
authors: G
authors: Marc
authors: B
authors: B
authors: Eyskens
authors: R
authors: R
authors: Heying
authors: B
authors: B
authors: Cools
authors: B
authors: B
authors: Meyns
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D011662:Pulmonary Subvalvular Stenosis / Q000175:diagnosis / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome