학술논문
Results of the Double Switch Operation in Patients Who Previously Underwent Left Ventricular Retraining.
Document Type
Academic Journal
Author
Mac Felmly L; Divisions of Pediatric Cardiac Surgery, Stanford Children's Hospital, Stanford, CA, USA.; Mainwaring RD; Divisions of Pediatric Cardiac Surgery, Stanford Children's Hospital, Stanford, CA, USA.; Ho DY; Pediatric Cardiology, Stanford Children's Hospital, Stanford, CA, USA.; Arunamata A; Pediatric Cardiology, Stanford Children's Hospital, Stanford, CA, USA.; Algaze C; Pediatric Cardiology, Stanford Children's Hospital, Stanford, CA, USA.; Hanley FL; Divisions of Pediatric Cardiac Surgery, Stanford Children's Hospital, Stanford, CA, USA.
Source
Publisher: Sage Publications Country of Publication: United States NLM ID: 101518415 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2150-136X (Electronic) Linking ISSN: 21501351 NLM ISO Abbreviation: World J Pediatr Congenit Heart Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Congenitally corrected transposition of the great arteries (CC-TGA) is a complex form of congenital heart disease that has numerous subtypes. While most patients with CC-TGA have a large ventricular septal defect (VSD) and pulmonary stenosis, there are some patients who have either no VSD or a highly restrictive VSD. These patients will require left ventricular (LV) retraining prior to double switch. The purpose of this study was to review our experience with the double switch procedure in patients who had previously undergone LV retraining.
Methods: This was a retrospective review of a single institution experience with the double switch procedure in patients who had undergone LV retraining (2002-present).
Results: Forty-five patients underwent double switch following LV retraining. Of these, 39 had an arterial switch with hemi-Mustard/bidirectional Glenn and six had a Senning. The median cross-clamp time was 135 min (range 71-272) and median bypass time was 202 min (range 140-430 min). Median hospital length of stay was eight days (range 4-108). There were no in-hospital deaths. Median duration of follow-up was 30 months (range 0-175). One patient subsequently underwent heart transplantation and died 65 months following double switch. At follow-up, 41 of the 44 survivors (93%) have normal or low normal LV function and 40 of the 44 survivors (91%) have no or trace mitral regurgitation.
Conclusions: The data demonstrate early and mid-term survival of 100% and 97%. Ninety-three percent had preserved LV function. These results suggest that patients with CC-TGA who undergo LV retraining and double switch can have excellent clinical outcomes.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Methods: This was a retrospective review of a single institution experience with the double switch procedure in patients who had undergone LV retraining (2002-present).
Results: Forty-five patients underwent double switch following LV retraining. Of these, 39 had an arterial switch with hemi-Mustard/bidirectional Glenn and six had a Senning. The median cross-clamp time was 135 min (range 71-272) and median bypass time was 202 min (range 140-430 min). Median hospital length of stay was eight days (range 4-108). There were no in-hospital deaths. Median duration of follow-up was 30 months (range 0-175). One patient subsequently underwent heart transplantation and died 65 months following double switch. At follow-up, 41 of the 44 survivors (93%) have normal or low normal LV function and 40 of the 44 survivors (91%) have no or trace mitral regurgitation.
Conclusions: The data demonstrate early and mid-term survival of 100% and 97%. Ninety-three percent had preserved LV function. These results suggest that patients with CC-TGA who undergo LV retraining and double switch can have excellent clinical outcomes.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.