Abstract
Between January 1987 and October 1992, 11 neonates and 2 infants (12 males and 1 female) underwent arterial switch operation (ASO). There were 9 simple transpositions of great arteries (TGA), 3 TGA with ventricular septal defect (VSD), and 1 double outlet of right ventricle (Taussig-Bing) with TGA. There were 12 cases of patent ductus arteriosus (PDA) and 6 cases of atrial septal defect (ASD). Nine patients had Yacoub type A coronary pattern, 3 had type B, and 1 had type D. The neonates' mean age was 15.5 days (one 120 days old and one 22 months old). The average body weight of the neonates was 4.2 kg. The Lecompte maneuver was performed on all patients. The average bypass time was 187.8 min, and mean aortic cross-clamp time was 76.2 min, with a mean circulatory arrest time of 10 min in 6 cases. Early hospital mortality was 15.4% (2 deaths)—1 patient died during operation from myocardial infarction, and another died postoperatively from poor heart function. All survivors experienced early postoperative heart failure and needed temporary inotropic support. One patient was lost to follow-up. The other 10 patients were free from any cardiac symptoms at follow-up, with good left ventricular function. Mild to moderate aortic regurgitation and stenosis and the same in the pulmonary valve were seen on echocardiogram. Seventeen months after ASO, 1 patient required reoperation for severe postoperative pulmonary stenosis. We concluded that ASO can be performed with an acceptable mortality rate in a new unit with no previous experience of such surgery.
Get full access to this article
View all access options for this article.