RESUMO
INTRODUCTION AND OBJECTIVES: Transposition of the great arteries is a prevalent congenital heart defect with a high survival rate and a good long-term outcome, especially if managed with early surgical intervention during the neonatal period. In this study, our main objective was to describe patient characteristics and outcomes and to identify possible predictors of early and long-term morbidity and mortality. METHODS: Retrospective analysis through review of clinical and surgical charts of patients with transposition of the great arteries admitted to the service of neonatology during 2000-2011. RESULTS: The study included 136 patients; 119 of them had undergone corrective surgery during the neonatal period. Patients were divided into 3 groups: group I, 81 cases of isolated transposition; group II, 24 cases with ventricular septal defect; and group III, 31 with "complex" transposition of the great arteries. The overall postoperative survival was 96.7% (115 of 119 patients); no patients from group I died after surgery. Duration of surgery, intubation, inotropic treatment, and length of stay were higher in patients in groups II and III. The overall survival rate after an average of 6 years of follow-up was 90.4% 123 of 136 patients, with no deaths after discharge in group I. The most frequent residual defect during cardiac follow-up was supravalvular pulmonary stenosis, in 33 of 113 patients that had follow-up data. CONCLUSIONS: In our study, the survival rate was high in patients with transposition of great arteries and especially in those undergoing arterial switch. The number of subsequent residual heart defects was low.
Assuntos
Comunicação Interventricular/cirurgia , Transposição dos Grandes Vasos/mortalidade , Transposição dos Grandes Vasos/cirurgia , Cardiotônicos/uso terapêutico , Procedimentos Cirúrgicos Cardiovasculares , Humanos , Recém-Nascido , Tempo de Internação , Duração da Cirurgia , Estudos RetrospectivosRESUMO
Introducción y objetivos. La transposición de grandes vasos es una cardiopatía congénita frecuente, con alta supervivencia y escaso número de secuelas, especialmente si se interviene precozmente, en el periodo neonatal. Nuestro objetivo es describir las características y la evolución de los pacientes afectados y determinar posibles factores pronósticos de morbimortalidad precoz y a largo plazo. Métodos. Estudio retrospectivo mediante revisión de historias clínicas y base de datos de los pacientes con transposición de grandes vasos ingresados entre los años 2000 y 2011. Resultados. Ingresaron 136 pacientes afectados de transposición de grandes vasos, de los que 119 se sometieron a cirugía correctora durante el periodo neonatal. Los pacientes se dividieron en tres grupos: grupo I , 81 transposición de grandes vasos simple; grupo II , 24 con comunicación interventricular concomitante, y grupo III , 31 transposiciones «complejas». La supervivencia postoperatoria fue de 96,7% (115 de 119 pacientes), aunque ningún paciente del grupo I falleció. La duración de la cirugía, la intubación y el uso posquirúrgico de inotrópicos y el tiempo de ingreso fueron mayores para los pacientes de los grupos II y III . Tras una media de 6 años de seguimiento, el 90,4% (123 de 136) de los pacientes estaban vivos. La lesión residual más frecuente en el seguimiento fue la estenosis supravalvular pulmonar en 33 de 113 pacientes seguidos. Conclusiones. En nuestro estudio, la supervivencia en el conjunto de pacientes con transposición de grandes vasos, y especialmente los sometidos a switch arterial, es alta. Los pacientes con formas más complejas tienen más complicaciones hospitalarias, pero no tras el seguimiento (AU)
Introduction and objectives. Transposition of the great arteries is a prevalent congenital heart defect with a high survival rate and a good long-term outcome, especially if managed with early surgical intervention during the neonatal period. In this study, our main objective was to describe patient characteristics and outcomes and to identify possible predictors of early and long-term morbidity and mortality. Methods. Retrospective analysis through review of clinical and surgical charts of patients with transposition of the great arteries admitted to the service of neonatology during 2000-2011. Results. The study included 136 patients; 119 of them had undergone corrective surgery during the neonatal period. Patients were divided into 3 groups: group I, 81 cases of isolated transposition; group II, 24 cases with ventricular septal defect; and group III, 31 with "complex" transposition of the great arteries. The overall postoperative survival was 96.7% (115 of 119 patients); no patients from group I died after surgery. Duration of surgery, intubation, inotropic treatment, and length of stay were higher in patients in groups II and III. The overall survival rate after an average of 6 years of follow-up was 90.4% 123 of 136 patients, with no deaths after discharge in group I. The most frequent residual defect during cardiac follow-up was supravalvular pulmonary stenosis, in 33 of 113 patients that had follow-up data. Conclusions. In our study, the survival rate was high in patients with transposition of great arteries and especially in those undergoing arterial switch. The number of subsequent residual heart defects was low (AU)
