The Journal of Thoracic and Cardiovascular Surgery, Vol 76, 312-320, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Total correction of transposition of the great arteries. Conduction disturbances in infants younger than three months of age
K Turley and PA Ebert
Although total physiological correction of d-transposition of the great
arteries (d-TGA) is technically feasible in infants, the optimal age for
correction has remained controversial because of concern regarding major
life-threatening arrhythmias and the long-term results of the intra-atrial
baffle procedure. During a 3 year period, 54 children aged 4 days to 5
years, including 24 infants aged 3 months or younger, underwent the baffle
procedure. Thirty-two children had simple transposition and underwent only
placement of a pericardial baffle; no deaths occurred in this group.
Twenty-two had complex transposition requiring in addition closure of a
ventricular septal defect (VSD) and/or resection of outflow tract
obstruction; there were four hospital and two late deaths in this group. A
single operative approach was used in all patients. Sinus rhythm was
present at discharge in 85 percent of the infants and 76 percent of the
older children. Three factors--age, mode of cardiopulmonary support, and
complexity of the lesion-- influenced these results.
