ARTERIAL
SWITCH OPERATION FOR NEONATES WITH COMPLETE TRANSPOSITION OF GREAT ARTERIES
Guo
Zhihe, Li Zhongzhi, Gao Ling, et al.
Department of Surgery,
Beijing Children’s Hospital, Beijing, China
Objective: Review
of our experience with the arterial switch operation (ASO) in
D-Transposition of the Great Arteries (D-TGA) with an intact ventricular
septum in neonates.
Methods: In
2000, four neonates
with D-TGA underwent ASO in Beijing children's hospital. The patients’ ages
and weights ranged from 2 to 11 days and 2.7 to 3.5 kg, respectively. Under
cardiopulmonary bypass, the ductus arteriosus was ligated and divided, and
the ascending aorta was dissected and freed from the main pulmonary artery.
The coronary arteries was mobilized and the pulmonary artery then was
distended. The coronary ostia were transferred
to the incisions on pulmonary artery with a countinuous 6-0 monofilament
absorbable suture. The coronary donor sites in the neopulmonary artery were
filled with two separate pericardial patches. The distal pulmonary artery was
anastomosed to the neopulmonary.
Results: The average cardiaopulmonary bypass
and aorta cross clamp duration were 179.8 and 147 minutes. The patients
recovered smoothly and were discharged from hospital 26 days
postoperatively. Two survived babies have got good early-term results.
Conclusions: Because it restores the heart physiology, the arterial
switch operation is considered the procedure of choice for correction of
transposition of the great arteries.