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[Clinical analysis of surgical procedures and outcomes for corrected transposition of great arteries with heart anomaly].
Zhonghua Wai Ke Za Zhi. 2008 Apr 15; 46(8):570-3.ZW

Abstract

OBJECTIVE

To determine the outcome of anatomically corrective repair and traditional repair of corrected transposition of great arteries (c-TGA) with heart anomaly.

METHODS

From April 2002 to December 2006, nineteen patients including fourteen male and five female with c-TGA, underwent operations, age ranged from 2 to 22 years old and weight ranged from 10 to 48 kg. Fifteen of them received anatomically corrective repair and the other four received traditional repair. Eighteen patients were referred to SLL (segmental anatomy) in situs solitus while fifteen of them with levocardia and three with dextrocardia. One patient was referred to IDD (segmental anatomy) in situs inversus with levocardia. Associated cardiac lesions included ventricular defect in eighteen patients, double outlet of right ventricle in one patient, pulmonary stenosis in seventeen patients and pulmonary hypertension in two patients. The operative procedures to anatomically correct atrioventricular discordance included an atrial switch plus a ventricle-arterial switch. The atrial switch was performed using the modified Senning procedure (n=13), Senning procedure (n=1) and Mustard procedure (n=1). The ventricle-arterial switch was performed using a Rastelli procedure (n=13) or an arterial switch (n=2). The patients underwent Mustard and Rastelli procedure had received bi-direct Gleen shunt due to postoperative high pressure of superior vena cava. Three patients underwent traditional cardiac repair because of small ventricular septal defect and one patient was reoperated to undergo traditional cardiac repair because of left ventricular failure after received anatomically corrective repair.

RESULTS

In the patients received anatomically corrective repair, there was one early operative death received a modified Senning atrial switch and an arterial switch. The cause of death was acute myocardial failure due to imperfect coronary transfer. The postoperative complications included severe low cardiac output syndrome (n=1), temporary atrioventricular block (n=1) and thorax cavity fluidify (n=1). The survivors were followed up for 6 months to 4 years. All were sinus cardiac rhythm and in NYHA class I or II. There was no death in the patients received traditional repair. Four patients were followed up for 1 year. Three patients were in NYHA I or II class and one patient in class II.

CONCLUSIONS

Anatomically corrective repair of c-TGA can be performed with good operative survival and intermediate-term outcome. The patients with good right ventricular function and well developed tricuspid valve who were difficult to undergo anatomically corrective repair might be fit to receive traditional repair.

Authors+Show Affiliations

Department of Cardiovascular Surgery, the General Hospital of Shenyang Military Region, Shenyang 110015, China. fangminhua@yahoo.com.cnNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

18844048

Citation

Fang, Min-hua, et al. "[Clinical Analysis of Surgical Procedures and Outcomes for Corrected Transposition of Great Arteries With Heart Anomaly]." Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], vol. 46, no. 8, 2008, pp. 570-3.
Fang MH, Zhu HY, Wang ZW, et al. [Clinical analysis of surgical procedures and outcomes for corrected transposition of great arteries with heart anomaly]. Zhonghua Wai Ke Za Zhi. 2008;46(8):570-3.
Fang, M. H., Zhu, H. Y., Wang, Z. W., Song, H. C., Zhang, N. B., & Zhe, J. (2008). [Clinical analysis of surgical procedures and outcomes for corrected transposition of great arteries with heart anomaly]. Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], 46(8), 570-3.
Fang MH, et al. [Clinical Analysis of Surgical Procedures and Outcomes for Corrected Transposition of Great Arteries With Heart Anomaly]. Zhonghua Wai Ke Za Zhi. 2008 Apr 15;46(8):570-3. PubMed PMID: 18844048.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical analysis of surgical procedures and outcomes for corrected transposition of great arteries with heart anomaly]. AU - Fang,Min-hua, AU - Zhu,Hong-yu, AU - Wang,Zeng-wei, AU - Song,Heng-chang, AU - Zhang,Nan-bin, AU - Zhe,Ji, PY - 2008/10/11/pubmed PY - 2009/4/14/medline PY - 2008/10/11/entrez SP - 570 EP - 3 JF - Zhonghua wai ke za zhi [Chinese journal of surgery] JO - Zhonghua Wai Ke Za Zhi VL - 46 IS - 8 N2 - OBJECTIVE: To determine the outcome of anatomically corrective repair and traditional repair of corrected transposition of great arteries (c-TGA) with heart anomaly. METHODS: From April 2002 to December 2006, nineteen patients including fourteen male and five female with c-TGA, underwent operations, age ranged from 2 to 22 years old and weight ranged from 10 to 48 kg. Fifteen of them received anatomically corrective repair and the other four received traditional repair. Eighteen patients were referred to SLL (segmental anatomy) in situs solitus while fifteen of them with levocardia and three with dextrocardia. One patient was referred to IDD (segmental anatomy) in situs inversus with levocardia. Associated cardiac lesions included ventricular defect in eighteen patients, double outlet of right ventricle in one patient, pulmonary stenosis in seventeen patients and pulmonary hypertension in two patients. The operative procedures to anatomically correct atrioventricular discordance included an atrial switch plus a ventricle-arterial switch. The atrial switch was performed using the modified Senning procedure (n=13), Senning procedure (n=1) and Mustard procedure (n=1). The ventricle-arterial switch was performed using a Rastelli procedure (n=13) or an arterial switch (n=2). The patients underwent Mustard and Rastelli procedure had received bi-direct Gleen shunt due to postoperative high pressure of superior vena cava. Three patients underwent traditional cardiac repair because of small ventricular septal defect and one patient was reoperated to undergo traditional cardiac repair because of left ventricular failure after received anatomically corrective repair. RESULTS: In the patients received anatomically corrective repair, there was one early operative death received a modified Senning atrial switch and an arterial switch. The cause of death was acute myocardial failure due to imperfect coronary transfer. The postoperative complications included severe low cardiac output syndrome (n=1), temporary atrioventricular block (n=1) and thorax cavity fluidify (n=1). The survivors were followed up for 6 months to 4 years. All were sinus cardiac rhythm and in NYHA class I or II. There was no death in the patients received traditional repair. Four patients were followed up for 1 year. Three patients were in NYHA I or II class and one patient in class II. CONCLUSIONS: Anatomically corrective repair of c-TGA can be performed with good operative survival and intermediate-term outcome. The patients with good right ventricular function and well developed tricuspid valve who were difficult to undergo anatomically corrective repair might be fit to receive traditional repair. SN - 0529-5815 UR - https://www.unboundmedicine.com/medline/citation/18844048/[Clinical_analysis_of_surgical_procedures_and_outcomes_for_corrected_transposition_of_great_arteries_with_heart_anomaly]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0529-5815&year=2008&vol=46&issue=8&fpage=570 DB - PRIME DP - Unbound Medicine ER -