Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Clinical Outcomes after Anatomic Repair Including Hemi-Mustard Operation in Patients with Congenitally Corrected Transposition of the Great Arteries

  • Shim, Man-shik (Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine) ;
  • Jun, Tae-Gook (Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine) ;
  • Yang, Ji-Hyuk (Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine) ;
  • Park, Pyo Won (Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine) ;
  • Cho, Yang Hyun (Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine) ;
  • Kang, Seok (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Huh, June (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Song, Jin Young (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2016.05.24
  • Accepted : 2016.10.20
  • Published : 2017.03.31
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Abstract

Background and Objectives: The aims of this study were to determine the early and late outcomes of anatomic repair of congenitally corrected transposition of the great arteries (ccTGA) and to evaluate effectiveness of the hemi-Mustard procedure. Subjects and Methods: We conducted a retrospective, single-center study of patients who underwent anatomic repair for ccTGA between July 1996 and December 2013. Sixteen patients were included in the study. The median age at the time of the operation was 3.5 years (range: 0.5-29.7), and the median body weight was 13.3 kg (range: 5.8-54). The median follow-up duration was 7.7 years (range: 0.2-17.4). Results: Atrial switch was achieved using the Mustard procedure in 12 patients (hemi-Mustard procedure in 11) or the Senning procedure in four patients. The ventriculoarterial procedure was performed using the Rastelli procedure in 11 patients and arterial switch in five patients. Six patients underwent tricuspid valvuloplasty. The survival rate was $93.8{\pm}6.1%$. The rate of freedom from reoperation at 5 years was $92.3{\pm}7.4%$ in the Rastelli group. All patients except one were New York Heart Association class I. All patients except one had mild tricuspid regurgitation. Conclusion: Anatomic repair can be performed with a low risk of in-hospital mortality. The hemi-Mustard strategy for selected patients is one solution for reducing early mortality and morbidity, and long-term complications such as venous pathway stenosis or sinus node dysfunction.

Keywords

References

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