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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

BECKER, Pedro et al. EARLY AND LATE RESULTS OF THE SWITCH OPERATION FOR D-TRANSPOSITION OF THE GREAT VESSELS: CLINICAL EXPERIENCE IN 108 PATIENTS OPERATED ON BETWEEN 1992 AND 2012. Rev Chil Cardiol [online]. 2013, vol.32, n.3, pp.204-213. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602013000300004.

Aim: to report the results of the arterial Switch operation in patients with D-transposition of the great vessels (D-TGA) and to evaluate their late course. Patients and Methods: A retrospective review of the clinical data on patients consecutively operated on for D-TGA using the switch procedure. Results obtained in patients operated on between 1992 and 2002 (Period 1) were compared to those obtained in patients undergoing their operation between 2013 and 2012. Patients with D-TGA and no complications were compared to those who had interventricular septal defect or aortic coarctation associated their TGA. Results: 44 patients belonged in Period 1 and 64 in Period 2 (total 108). Demographic and anatomical characteristics were similar in both periods. Simple D-TGA was present in 70 patients and complex D-TGA in 38. Operative mortality was higher in Period 1 compared to Period 2 (33% vs. 8.4%, p<0.025). A higher, albeit not statiscally significant mortality was observed in patients with complex as opposed to simple D-TGA. A 68.7% relative reduction mortality risk was observed in Period 2. Complications developed in 28.7% of patients, with no difference between periods. Only 1 patient died during late follow up. Median follow up was 60 months and survival rate was 84.3% at 10 y 20 years. Sixteen patients required re-intervention, mainly to perform percutaneous plastic procedures on pulmonary artery branches. Most patients had an asymptomatic course during follow up. Surgical mortality for the last 5 years was 2.6%. Conclusion: surgical mortality for the arterial switch operation in patients with D-TGA has significantly decreased along a 20 year period. An increased surgical risk persists for patients with certain forms of coronary artery anomalies. Late survival free of re-intervention was the rule in these patients.

Keywords : Transposition of the great vessels; D-TGA; Switch operation; clinical series.

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