Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Clinical features and surgical outcomes of complete transposition of the great arteries

  • Hong, Suk Jin (Department of Pediatrics, Kyungpook National University School of Medicine) ;
  • Choi, Hee Joung (Department of Pediatrics, CHA Gumi Medical Center, CHA University College of Medicine) ;
  • Kim, Yeo Hyang (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Hyun, Myung Chul (Department of Pediatrics, Kyungpook National University School of Medicine) ;
  • Lee, Sang Bum (Department of Pediatrics, Kyungpook National University School of Medicine) ;
  • Cho, Joon Yong (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University School of Medicine)
  • Received : 2011.07.08
  • Accepted : 2012.07.09
  • Published : 2012.10.15
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Abstract

Purpose: This single-center study aimed to assess the clinical features and surgical approaches and outcomes of complete transposition of the great arteries (TGA). Methods: TGA patients who had undergone surgical correction at the Kyungpook National University Hospital from January 2000 to December 2010, were retrospectively evaluated for patient characteristics, clinical manifestation, preoperative management, intraoperative findings, postoperative progress, and follow-up status. Results: Twenty-eight patients (17 boys and 11 girls, mean age=$10.6{\pm}21.5$ days) were included and were categorized as follows: group I, TGA with intact ventricular septum (n=13); group II, TGA with ventricular septal defect (VSD, n=12); and group III, TGA/VSD with pulmonary stenosis (n=3). Group I underwent the most intensive preoperative management (balloon atrial septostomy and prostaglandin E1 medication). Group II showed the highest incidence of heart failure (P<0.05). Usual and unusual coronary anatomy patterns were observed in 20 (71%) and 8 patients, respectively. Arterial and half-turned truncal switch operations were performed in 25 and 3 patients (Group III), respectively. Postoperative complications included cardiac arrhythmias (8 patients), central nervous system complications (3 patients), acute renal failure (1 patient), infections (3 patients), and cardiac tamponade (1 patient), and no statistically significant difference was observed between the groups. Group II showed the mildest aortic regurgitation on follow-up echocardiograms (P<0.05). One patient underwent reoperation, and 1 died. The overall mortality rate was 4%. Conclusion: Our study showed favorable results in all the groups and no significant difference in postoperative complication, reoperation, and mortality among the groups. However, our results were inadequate to evaluate the risk factors for reoperation and mortality owing to the small number of patients and short follow-up duration.

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References

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