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[Current status of Jatene's operation].

H Yasui, H Sumi, K Yonenaga

    Kyobu Geka. the Japanese Journal of Thoracic Surgery
    |July 1, 1989
    PubMed
    Summary

    Jatene's operation, or arterial switch, is the preferred surgical treatment for transposition of the great arteries. This procedure offers low mortality and complication rates, ensuring excellent long-term outcomes.

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    Area of Science:

    • Cardiovascular Surgery
    • Pediatric Cardiology
    • Congenital Heart Disease

    Context:

    • Transposition of the great arteries (TGA) is a critical congenital heart defect.
    • Jatene's operation, an arterial switch procedure, has evolved as the primary surgical intervention for TGA.
    • Evaluating the efficacy and safety of the arterial switch operation is crucial for pediatric cardiac surgery.

    Purpose:

    • To review the current status and outcomes of Jatene's operation for TGA.
    • To analyze the authors' results and compare them with existing literature.
    • To present surgical techniques that mitigate common postoperative complications.

    Summary:

    • The arterial switch operation demonstrates low surgical mortality (4.5% in the author's series) and a low incidence of postoperative complications.

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  • Specific surgical techniques are detailed to prevent bleeding, coronary artery kinking, aortic insufficiency, and pulmonary stenosis.
  • One-stage anatomic correction in neonates, performed in high-volume centers, achieves mortality rates below 10% (7% in the author's series) with favorable postoperative left ventricular function.

    • Impact:

    • The arterial switch operation is established as the gold standard for TGA correction.
    • Improved surgical techniques contribute to better patient outcomes and reduced morbidity.
    • Advocacy for one-stage neonatal correction is supported by evidence of low mortality and preserved cardiac function.