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Surgical treatment of transposition of the great arteries
Insights
Surgical correction for d-transposition of the great arteries (d-TGA) in 171 patients showed a 96% 30-day survival rate. Atrial inversion techniques for simple TGA demonstrated promising outcomes, with the Senning technique noted for better atrial growth potential.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Between 1974 and 1979, surgical interventions were performed on 171 patients diagnosed with d-transposition of the great arteries (d-TGA).
- A significant subset of 109 patients underwent corrective surgical procedures.
- Hemodynamic correction using atrial inversion techniques was applied to 77 patients with simple TGA.
Purpose of the Study:
- To describe diagnostic methods, surgical indications, and procedures for d-TGA.
- To evaluate the outcomes of surgical correction for d-TGA and simple TGA.
- To compare the Mustard and Senning techniques in infants with simple TGA.
Main Methods:
- Surgical correction for d-TGA.
- Atrial inversion techniques for hemodynamic correction in simple TGA.
- Comparison of Mustard and Senning techniques in infants under 2 years with simple TGA.
Main Results:
- A 30-day survival rate of 96% was achieved for the 171 patients with d-TGA.
- Three late deaths were recorded, with one reoperation for superior vena cava obstruction.
- In simple TGA, mortality was one patient in both Mustard and Senning technique groups, but the Senning technique showed better atrial growth potential and a lower incidence of arrhythmia.
Conclusions:
- Surgical correction for d-TGA demonstrates high short-term survival rates.
- Atrial inversion techniques are effective for hemodynamic correction in simple TGA.
- The Senning technique may be preferable for simple TGA in infants due to better atrial growth and potentially fewer arrhythmias.
Abstract:
Between 1974 and 1979 171 patients with d-TGA were treated surgically, 109 had correcting operations. 77 patients with simple TGA had hemodynamic correction by atrial inversion techniques. 30 day survival rate was 96%. There were 3 late deaths. One patient had reoperation for superior vena cava obstruction. The methods of diagnosis, indication of surgery and the surgical procedure are described. Results of the Mustard technique (33 patients) technique in infants less than 2 years of age with simple TGA. Mortality was one patient in each group. The incidence of arrhythmia was greater with the senning technique. Better growth potential of the atria with the Senning technique warrants further use of this method.