[Results of arterial switch operation for transposition of great arteries with regard to coronary pattern]
1Department of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan.
Insights
Coronary events (CE) impact arterial switch operation (ASO) outcomes in complete transposition of great arteries (TGA). This study identified risk factors for CE in TGA patients undergoing ASO, excluding specific coronary patterns.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
- Cardiovascular Surgery
Context:
- Arterial switch operation (ASO) is a primary surgical treatment for complete transposition of great arteries (TGA).
- Coronary events (CE) are a significant determinant of postoperative outcomes following ASO.
- Understanding CE risk factors is crucial for improving ASO success rates in TGA patients.
Purpose:
- To analyze risk factors associated with coronary events (CE) after arterial switch operation (ASO).
- To investigate CE in patients with specific coronary patterns (excluding Shaher type 1) undergoing ASO for TGA.
- To evaluate the impact of different coronary reconstructive techniques on CE incidence.
Summary:
- A cohort of 44 patients with TGA, operated between 1994 and 2007, were analyzed for CE risk factors.
- Coronary reconstructive techniques included Mee, Aubert, or conventional methods, with pulmonary artery reconstruction using autopericardium and Lecompt maneuver.
- 14 patients (32%) experienced CE, with a mean onset of 1.6 years post-surgery, over a mean follow-up of 4.0 years.
Impact:
- Identifies specific risk factors for coronary events in TGA patients undergoing ASO.
- Provides insights into the effectiveness of different coronary reconstructive techniques.
- Contributes to optimizing surgical strategies to reduce CE and improve long-term outcomes in TGA repair.
Abstract:
One of the factors determing the postoperative results of arterial switch operation (ASO) for complete transposition of great arteries (TGA) is coronary event (CE). We analyzed the risk factors of CE after ASO in patients whose coronary patterns excluding Shaher type 1. The subjects were 44 patients operated from 1994 to 2007. As for the coronary reconstructive technique, procedures by Mee or Aubert were conducted on patients with Shaher 5A intramural type. The conventional technique was conducted on other patients, with or without trapdoor technique. In all patients, the pulmonary artery was reconstructed mainly with autopericardium using Lecompt maneuver. The mean observation period was 4.0 +/- 3.1 years, and the number of patients showing CE was 14 (32%) at 1.6 years after surgery on the average. The risk factors of CE and the operative procedures were discussed.
