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KMID : 0364019960290030278
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Korean Journal of Thoracic and Cardiovascular Surgery
1996 Volume.29 No. 3 p.278 ~ p.284
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Arterial Switch Operation for Transposition of Great Arteries
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이호철
류한영/정태은/디동협/이정철/한승세/이영환
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Abstract
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Nine infants with transposition of great arteries have undergone arterial switch operation from May 1989 to May 1994 in the Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. Patients' age ranged from 3 days to 90
days,
averaging 30±21 days. Diagnosis was made by two-dimensional echocardiography in all patients. Eight patients were diagnosed as transposition of great arteries with ventricular septal defect and one patient was a simple transposition of great
arteries.
Associated anomalies were patent ductus arteriosus(8), atrial septal defect(7) and coarctation of aorta(1). The anatomy of the coronary arteries were 7(77%) type A and 2(23%) type D according to the Yacoub classification. Pulmonary artery
reconstruction
was done according to Lecompte maneuver with autologous pericardial patch in 8 patients. Overall operative mortality rate was 55%. Left heart failure and pulmonary hypertensive crisis were the cause of death on postoperative 1~2 days in patients,
and
two succumbed to death due to sepsis on postoperative 2~3 weeks. The mean follow-up period was mean 17 months. No patient had clinically significant postoperative aortic regurgitation and supravalvular pulmonary stenosis. The excessive use of
inotropic
support postoperatively was identified as a stastically significant risk factor following the arterial switch operation. But other variables such as low body weight long cardiopulmonary bypass time, excessive hemodilution during cardiopulmonary
bypass,
hypothermia and volume loading were not significant risk factors.
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KEYWORD
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