Clinical use of arterial switch operation for the complex congenital heart defects with ventriculoarterial connection anomaly / 中华胸心血管外科杂志

ABSTRACT

Objective To summarizes the clinical experience of the arterial switch operation (ASO) for the complex congenital heart defects with ventriculoarterial connection anomaly. Methods Between January 2000 and August 2004, 60 consecutive neonatal and infants, aged 2 days to 11 years with mean body weight (6.5?4.3)kg (2.6～22 kg), underwent the arterial switch operation at Fu Wai hospital, including 42 patients in early years (2000.1～2003.5), and eighteen patients in recent years (2003.6～2004.8). Primary cardiac diagnoses included transposition of the great arteries (TGA, n=49) and Taussing-Bing anomaly (TBA, n=7), and the congenitally corrected transposition of the great arteries (ccTGA, n=4). The operation was performed under general anesthesia and extracorporeal circulation with the low temperature and low volume blood flow. The great arteries were transected above the valvular commissures; the coronary ostia with all the adjacent sinus of valsalva were excised and reimplanted to the proximal neo-aorta. The proximal neo-pulmonary trunk was reconstructed with a large autologous native pericardium as a pantatoon patch. The pulmonary anastomosis was completed after the aortic cross-clamp was released. The VSDs were repaired through the atrium or proximal aorta with dacron patches. For the patients with ccTGA, double switch operation included Senning procedure and ASO were performed. Results The total operative mortality rate was 16.7% (10 cases), 9 cases in early years (21.4%, 9/42) and 1 case in recent year (5.6%, 1/18), two groups had significant difference (P