The clinical research of double switch operation with Glenn and hemi-Mustard in CC-TGA in children / 中华胸心血管外科杂志

ABSTRACT

Objective To avoid complications associated with the complete Senning procedures and to assist right-heart hemodynamics, this study was undertaken to assess the risks and benefits of the double-switch operation using a hemi-Mustard atrial switch procedure and the bidirectional Glenn operation for congenitally corrected transposition of the great arteries. we fa-vor a modified atrial switch procedure. Methods Between January 2014 and March 2016, anatomic repair was achieved in 26 patients. A hemi-Mustard procedure was the atrial switch procedure for 26. 9％(7/26). The Rastelli-atrial switch procedure was performed in 5 patients( RAS) and the arterial-atrial switch procedure was performed in 2 patients( AAS) . Results There was no in-hospital death after anatomic repair. There were no late deaths in a median follow-up of 7-21 months. Glenn opera-tion complications were uncommon limited to the perioperative period, atrial baffle-related reoperations or sinus node dysfunc-tion had not been observed. Tricuspid regurgitation decreased to mild for 1 case and mild to moderate for 6 cases. Right ventri-cle-pulmonary artery conduit longevity was significantly improved. Conclusion We recentely describe an experience with the double-switch operation using a modified atrial switch procedure with favorable earlyterm results. The risks of the hemi-mustard and bidirectional Glenn operation are minimal and are limited to a well-defined patient subset. The benefits include reduced baffle-and sinus node-related complications, technical simplicity and inspiring results.