Yi Chang1, Shoujun Li2, Hao Zhang1, Zhongdong Hua1, Keming Yang1, Huawei Gao1. 1. State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Centre for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Paediatric Cardiovascular Institute, Beijing, China. 2. State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Centre for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Paediatric Cardiovascular Institute, Beijing, China drlishoujunfw@163.com.
Abstract
OBJECTIVES: To assess the function of the left ventricular outlet tract and neoaortic valve after arterial switch operation for patients with transposition of the great arteries and left ventricular outlet tract obstruction. METHODS: The data of 40 patients, who underwent arterial switch surgery with transposition of the great arteries with left ventricular outlet tract obstruction and a concomitant left ventricular outlet tract obstruction relieving procedure, were retrospectively analysed. Ultrasonic cardiogram and intraoperative findings, surgical methods and early and follow-up results were also summarized. RESULTS: Early death occurred in one case. One patient died in follow-up stage and 3 patients were lost during follow-up. In all the 35 patients accepting follow-up, 1 patient had a reoccurring left ventricular outlet tract obstruction, 1 patient had mild neoaortic stenosis, whereas mild and moderate neoaortic regurgitation occurred in 11 and 2 patients, respectively. The median pressure gradient across the left ventricular outlet tract was 6.8 mmHg (range: 2-49 mmHg) during follow-up which was statistically significant compared with that before surgery. We defined death, reintervention and rehospitalization for cardiac reasons as a cardiac event; the survival rate of being free from cardiac event for 1 year and 5 years was 92.8 ± 0.04%, respectively. CONCLUSIONS: Anatomical features and pressure gradient should be used together to evaluate the severity of obstruction, whereas the mid-term outcomes can be satisfied after arterial switch operation for the appropriate candidates.
OBJECTIVES: To assess the function of the left ventricular outlet tract and neoaortic valve after arterial switch operation for patients with transposition of the great arteries and left ventricular outlet tract obstruction. METHODS: The data of 40 patients, who underwent arterial switch surgery with transposition of the great arteries with left ventricular outlet tract obstruction and a concomitant left ventricular outlet tract obstruction relieving procedure, were retrospectively analysed. Ultrasonic cardiogram and intraoperative findings, surgical methods and early and follow-up results were also summarized. RESULTS: Early death occurred in one case. One patient died in follow-up stage and 3 patients were lost during follow-up. In all the 35 patients accepting follow-up, 1 patient had a reoccurring left ventricular outlet tract obstruction, 1 patient had mild neoaortic stenosis, whereas mild and moderate neoaortic regurgitation occurred in 11 and 2 patients, respectively. The median pressure gradient across the left ventricular outlet tract was 6.8 mmHg (range: 2-49 mmHg) during follow-up which was statistically significant compared with that before surgery. We defined death, reintervention and rehospitalization for cardiac reasons as a cardiac event; the survival rate of being free from cardiac event for 1 year and 5 years was 92.8 ± 0.04%, respectively. CONCLUSIONS: Anatomical features and pressure gradient should be used together to evaluate the severity of obstruction, whereas the mid-term outcomes can be satisfied after arterial switch operation for the appropriate candidates.
Authors: George E Sarris; Andrew C Chatzis; Nicolas M Giannopoulos; George Kirvassilis; Hakan Berggren; Mark Hazekamp; Thierry Carrel; Juan V Comas; Duccio Di Carlo; Willem Daenen; Tjark Ebels; Josè Fragata; Victor Hraska; Vladimir Ilyin; Harald L Lindberg; Dominique Metras; Marco Pozzi; Jean Rubay; Heikki Sairanen; Giovanni Stellin; Andreas Urban; Carin Van Doorn; Gerhard Ziemer Journal: J Thorac Cardiovasc Surg Date: 2006-08-02 Impact factor: 5.209
Authors: John W Brown; Mark Ruzmetov; Daniel Huynh; Mark D Rodefeld; Mark W Turrentine; Andrew C Fiore Journal: Ann Thorac Surg Date: 2011-01 Impact factor: 4.330