Újszülöttkorban és később végzett primer artériás switchműtétek eredményei egy újonnan létrehozott, átfogó congenitalis szívközpontban

2015 ◽  
Vol 156 (25) ◽  
pp. 1014-1019
Author(s):  
László Király ◽  
Csaba Tamás
Keyword(s):  
Ventricular Septal Defect ◽  
Mechanical Circulatory Support ◽  
Septal Defect ◽  
Arterial Switch Operation ◽  
Tertiary Care ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Associated Anomalies ◽  
Arterial Switch ◽  
Transverse Arch

Introduction: Outcome of arterial switch operation for transposition of the great arteries with/without ventricular septal defect is a service key-performance-indicator. Aim: The aim of the authors was to assess patient characteristics and parameters in the perioperative course. Method: In the setting of a newly-established, comprehensive tertiary-care center, primary complete repair was performed including associated anomalies, e.g. transverse arch repairs. Patients with d-transposition were grouped according to coexistence of ventricular septal defect. Results: 118 arterial switch operations were performed between 2007 and 2014 with 96.62% survival (114/118). Ventricular septal defect and repair of associated anomalies did not yield worse outcome. Left ventricular re-training with late presentation necessitated mechanical circulatory support for 4.5±1.5 days. Conclusions: D-transposition is suitable for standardization of clinical algorithm and surgical technique. Quality standards contribute to excellent outcomes, minimize complications, and serve as blueprint for other neonatal open-heart procedures. Availability of mechanical circulatory support is key for single-stage left ventricular re-training beyond the neonatal period. Orv. Hetil., 2015, 156(25), 1014–1019.

Left ventricular retraining after arterial switch operation facilitated by mechanical circulatory support

2013 ◽  
Vol 32 (8) ◽  
pp. 842-843 ◽  
Author(s):  
Luca Di Chiara ◽  
Zaccaria Ricci ◽  
Gianluca Brancaccio ◽  
Fabrizio Gandolfo ◽  
Antonio Amodeo
Keyword(s):  
Mechanical Circulatory Support ◽  
Arterial Switch Operation ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Arterial Switch ◽  
Switch Operation

Arterial Switch Operation With Neoaortic Valve Replacement in a 13-Year Old Patient With Transposition of Great Arteries With Ventricular Septal Defect and Left Ventricular Outflow Tract Obstruction—A Case Report

2018 ◽  
Vol 11 (4) ◽  
pp. NP190-NP194
Author(s):  
Kuntal Roy Chowdhuri ◽  
Manoj Kumar Daga ◽  
Subhendu Mandal ◽  
Pravir Das ◽  
Amanul Hoque ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Valve Replacement ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Arterial Switch Operation ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Transposition Of Great Arteries ◽  
Switch Operation ◽  
Left Ventricular Outflow

The surgical management of d-transposition of great arteries (d-TGAs) with ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO) is ever evolving and still remains a challenge because of wide anatomic variability, age of presentation, surgical options available, and their variable long-term results in different series. We describe a patient with d-TGA, VSD, and LVOTO who presented to us at 13 years of age and underwent an arterial switch operation along with neoaortic valve replacement with a mechanical prosthesis. The postoperative course was uneventful, and at hospital discharge, the echocardiogram was satisfactory. We present the pros and cons of this hitherto undescribed treatment option.

Primary Intracardiac Repair of Double Outlet Right Ventricle and Ventricular Septal Defect without Pulmonary Stenosis

1995 ◽  
Vol 3 (3-4) ◽  
pp. 103-108
Author(s):  
KG Jaya Prasanna ◽  
Krishna Subramony Iyer ◽  
Rajesh Sharma ◽  
Balram Airan ◽  
Ivatury Mrityonjaya Rao ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Arterial Switch Operation ◽  
Pulmonary Stenosis ◽  
Double Outlet Right Ventricle ◽  
Arterial Switch ◽  
Intracardiac Repair ◽  
Switch Operation

From January 1991' to May 1994, 29 patients with double outlet right ventricle with ventricular septal defect, without pulmonary stenosis underwent primary intracardiac repair at the All India Institute of Medical Sciences, New Delhi. Patients were classified into 4 groups based on location of the ventricular septal defect. The ventricular septal defect was subaortic in 11, subpulmonary in 13, doubly committed subarterial in 1, and noncommitted in 4 patients. Surgical treatment consisted of intraventricular routing of the left ventricle to the aorta (17), and the left ventricle to the pulmonary artery followed by an arterial switch operation (12). There were 4 (13.9%) early deaths. Follow-up ranged from 3 months to 3 years (mean, 1.5 years). There was no late mortality. Three patients had residual ventricular septal defect, one of whom has undergone reoperation. One patient has a gradient of 25 mmHg across the left ventricular outflow tract. Double outlet right ventricle with subpulmonic ventricular septal defect was found to be a significant risk factor for early mortality (p = 0.03). The subgroup of double outlet right ventricle with subpulmonic ventricular septal defect who had a combination of single coronary artery and post arterial switch operation was particularly prone to pulmonary hypertensive crisis and hospital death (p = 0.002).

Transposition of the great vessels and intact ventricular septum: is there an age limit for the arterial switch? Personal experience and review of the literature

2020 ◽  
Vol 30 (7) ◽  
pp. 1012-1017
Author(s):  
Zied Daoud ◽  
Halkawt Ali Nuri ◽  
Ambra Miette ◽  
Giuseppe Pomè
Keyword(s):  
Myocardial Dysfunction ◽  
Arterial Switch Operation ◽  
Left Ventricular ◽  
Ventricular Septum ◽  
Circulatory Support ◽  
Intact Ventricular Septum ◽  
Arterial Switch ◽  
Switch Time ◽  
Switch Operation ◽  
Great Vessels

AbstractObjective:Prognosis of the transposition of the great arteries has completely changed since the introduction of the arterial switch. Time limit to perform this intervention is still controversial. The aim of this study is to demonstrate the early and late outcome of primary arterial switch operation beyond the age of months.Methods:We included all patients with the diagnosis of transposition of the great arteries with intact ventricular septum beyond the age of 8 weeks who underwent primary arterial switch operation. The procedures were performed by the same surgeon, in two different institutes. Patients who had transposition of the great arteries and associated anomalies (except atrial septal defect and persistent arterial duct) were excluded. Ventricular shape, geometry, and mass were not considered during the decision on procedure type.Results:In the study, 11 patients with the diagnosis of simple d-transposition of the great arteries beyond 8 weeks were undergone primary arterial switch operation with a mean age of 90.63 days (60–137 days), and 7 patients had a Rashkind procedure. All patients had squashed left ventricle shape with preserved function. The sternum was left open in 10 patients. Extracorporeal membrane oxygenation support was necessary in 45.45% of cases. The mean mechanical ventilation time was 7.27 days (1–16 days). No mortality was recorded until now. Post-operatory left ventricular function was preserved in 90.9% of the patients. Only one patient had mild myocardial dysfunction at the time of discharge.Conclusions:Primary arterial switch procedure can still be the best surgical option in patients with the diagnosis of transposition of the great arteries with intact ventricular septum beyond 8 weeks of age, providing that mechanical circulatory support and an expert cardiac intensive care unit service are available.

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