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The Journal of Thoracic and Cardiovascular Surgery, Vol 92, 361-384, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JM Quaegebeur, J Rohmer, J Ottenkamp, T Buis, JW Kirklin, EH Blackstone and AG Brom
Sixty-six patients (23 neonates with transposition of the great arteries
and intact ventricular septum, 33 infants and children with transposition
and a large ventricular septal defect, and 10 with double- outlet right
ventricle with a subpulmonary ventricular septal defect have received an
arterial switch repair since 1977. Eight (one with transposition and intact
ventricular septum, six with transposition and ventricular septal defect,
and one with double-outlet right ventricle with subpulmonary ventricular
septal defect) died in the hospital. All other patients have had follow-up
as of June, 1985. Including the hospital deaths, the 11 month actuarial
survival rate for the entire group was 81%, and no deaths have occurred
among the 33 patients alive at that time and traced as long as 8 years. The
hazard function for death has only a single early phase, and its 70%
confidence limits overlap the hazard function of a matched general
population by 12 months after the operation. Incremental risk factors for
death included low birth weight (but not weight or age at operation),
transposition of the great arteries with large ventricular septal defect,
double-outlet right ventricle with subpulmonary ventricular septal defect,
and presence of a patent ductus arteriosus. Coronary artery morphology and
position of the great arteries were not risk factors. Long aortic cross-
clamp time was possibly (p = 0.11) a risk factor. Early date of operation
was a risk factor (p = 0.004); thus, predicted 1 year survival rate,
including hospital deaths, after the arterial switch operation in 1985 is
99.9% (70% confidence limits 99.0%-100%) for neonates with transposition
and intact ventricular septum and 99.7% (98.4%-99.9%) for those with
transposition and a large ventricular septal defect or double-outlet right
ventricle. The late functional status was excellent, and the rhythm was
sinus in 96% of the 55 surviving patients. A formal comparison with the
results of the atrial switch repair indicates that the arterial switch
repair is superior.
ARTICLES
The arterial switch operation. An eight-year experience
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A. F. Rossi, H. S. Seiden, A. M. Sadeghi, K. H. Nguyen, C. S. Quintana, R. P. Gross, and R. B. Griepp The outcome of cardiac operations in infants weighing two kilograms or less J. Thorac. Cardiovasc. Surg., July 1, 1998; 116(1): 28 - 32. [Abstract] [Full Text]
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S. Nogi, B. W. McCrindle, C. Boutin, W. G. Williams, R. M. Freedom, and L. N. Benson Fate Of The Neopulmonary Valve After The Arterial Switch Operation In Neonates J. Thorac. Cardiovasc. Surg., March 1, 1998; 115(3): 557 - 562. [Abstract] [Full Text]
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K. S. Murthy and K. M. Cherian A NEW TECHNIQUE OF ARTERIAL SWITCH OPERATION WITH IN SITU CORONARY REALLOCATION FOR TRANSPOSITION OF GREAT ARTERIES J. Thorac. Cardiovasc. Surg., July 1, 1996; 112(1): 27 - 32. [Abstract] [Full Text]
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K. Turley and E. D Verrier Intermediate Results From the Period of the Congenital Heart Surgeons Transposition Study: 1985 to 1989 Ann. Thorac. Surg., September 1, 1995; 60(3): 505 - 510. [Abstract] [Full Text]
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H. Uemura, T. Yagihara, Y. Kawashima, F. Yamamoto, K. Nishigaki, O. Matsuki, T. Kamiya, S. Y. Ho, and R. H. Anderson A Bicuspid Pulmonary Valve Is Not a Contraindication for the Arterial Switch Operation Ann. Thorac. Surg., February 1, 1995; 59(2): 473 - 476. [Abstract] [Full Text]
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G. Wernovsky, J. E. Mayer Jr., R. A. Jonas, F. L. Hanley, E. H. Blackstone, J. W. Kirklin, and A. R. Castaneda Factors influencing early and late outcome of the arterial switch operation for transposition of the great arteries J. Thorac. Cardiovasc. Surg., February 1, 1995; 109(2): 289 - 302. [Abstract] [Full Text]
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E. K. W. Sim, J. A. M. van Son, W. D. Edwards, and F. J. Puga Congenital ostial membrane of right coronary artery in complete transposition of the great arteries J. Thorac. Cardiovasc. Surg., June 1, 1994; 107(6): 1538 - 1539. [Full Text]
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M. R. de Leval, K. Francois, C. Bull, W. Brawn, and D. Spiegelhalter Analysis of a cluster of surgical failures: Application to a series of neonatal arterial switch operations J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 914 - 924. [Abstract] [Full Text]
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M. Aoki, J. M. Forbess, R. A. Jonas, J. E. Mayer Jr., and A. R. Castaneda Result of biventricular repair for double-outlet right ventricle J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 338 - 350. [Abstract] [Full Text]
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