Double switch operation for congenital corrected transposition of great arteries with heart anomaly / 中华胸心血管外科杂志

ABSTRACT

Objective To report the outcomes of double switch operation as the primary approach for congenital corrected transposition of great arteries (cTGA) with heart anomaly. Methods From April 2002 to June 2004, seven patients ranged 4 to 15 years with cTGA underwent double switch operation. Six patients were situs solitus (SLL segmental anatomy) while one patient was situs inversus (IDD segmental anatomy). The heart defects included ventricular septal defect in 6 cases, secondary atrial septal defect in, double outlet of right ventricle in 1, pulmonary stenosis in 6, dextrocardia in 3 and levocardia in 1. The operative procedures comprised of 4 modified Senning+Rastelli, Mustard +Rastelli +bidirectional Glenn, 1 Senning +Rastelli, 1 modified Senning+switch. Results There was one early operative death after modified Senning+switch operation. The cause of death was left ventricular failure. The postoperative complications included severe low cardiac output syndrome in 1, temporary atrioventricular block in 1, pleurisy and low plasma protein in 2. The survivors were followed up from 2 to 24 months, all of them were in sinus cardiac rhythm except one case with junction cardiac rhythm. All were in NYHA I class. Conclusion Anatomic correction of cGTA by double switch operation can be performed with lower operative mortality and good medial-term outcome. In the SLL cases, modified Senning operation may yield better outcomes than Mustard operation.