Contemporary outcomes of the double switch operation for congenitally corrected transposition of the great arteries.
J Thorac Cardiovasc Surg
; 164(6): 1980-1990.e7, 2022 12.
Article
en En
| MEDLINE
| ID: mdl-35688715
ABSTRACT
OBJECTIVE:
To determine the contemporary outcomes of the double switch operation (DSO) (ie, Mustard or Senning + arterial switch).METHODS:
A single-institution, retrospective review of all patients with congenitally corrected transposition of the great arteries undergoing a DSO.RESULTS:
Between 1999 and 2019, 103 patients underwent DSO with a Mustard (n = 93) or Senning (n = 10) procedure. Segmental anatomy was (S, L, L) in 93 patients and (I, D, D) in 6 patients. Eight patients had heterotaxy and 71 patients had a ventricular septal defect. Median age was 2.1 years (range, 1.8 months-40 years), including 34 patients younger than age 1 year (33%). Median weight was 10.9 kg (range, 3.4-64 kg). Sixty-one patients had prior pulmonary artery bands for a median of 1.1 years (range, 14 days-12.9 years; interquartile range, 0.7-3.1 years). Median intensive care unit and hospital lengths of stay were 5 and 10 days, respectively. Median follow-up was 3.4 years (interquartile range, 1-9.8 years) and 5.2 years (interquartile range, 2.3-10.7 years) in 79 patients with >1 year follow-up. At latest follow-up, aortic, mitral, tricuspid valve regurgitation, and left ventricle dysfunction was less than moderate in 96%, 98%, 96%, and 93%, respectively. Seventeen patients underwent reoperation neoaortic valve intervention (n = 10), baffle revision (n = 5), and ventricular septal defect closure (n = 4). At latest follow-up, 17 patients (17%) had a pacemaker and 27 (26%) had cardiac resynchronization therapy devices. There were 2 deaths and 2 transplants. Transplant-free survival was 94.6% at 5 years. Risk factors for death or transplant included longer cardiopulmonary bypass time and older age at DSO.CONCLUSIONS:
The outcomes of the DSO are promising. Earlier age at operation might favor better outcomes. Progressive neoaortic regurgitation and reinterventions on the neo-aortic valve are anticipated problems.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Transposición de los Grandes Vasos
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Operación de Switch Arterial
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Defectos del Tabique Interventricular
Tipo de estudio:
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Child, preschool
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Humans
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Infant
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Año:
2022
Tipo del documento:
Article