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Follow-up of Patients Who Underwent Arterial Switch Repair for Transposition of the Great Arteries

Follow-up of Patients Who Underwent Arterial Switch Repair for Transposition of the Great Arteries Abstract • Thirty infants underwent arterial switch for transposition of the great arteries within the first week of life (mean age, 2.8 days). An additional three patients underwent repair at 5½, 8, and 9½ months of age. Six (18.2%) of 33 patients died. All the survivors were not receiving cardiac medications or diuretics at the time of the last follow-up visit. Examination of 24 of 27 survivors at 1 to 5 years of age revealed normal growth in 75% of the patients. Two patients had height, weight, and head circumference below the fifth percentile for age. Four patients had height and weight appropriate for age but head circumference below the fifth percentile. Neurodevelopmental testing yielded normal findings in 18 patients. Three patients were considered suspect and an additional three were abnormal neurodevelopmentally. Head circumference less than the fifth percentile, abnormalities on computed tomographic scans of the brain, and emergency balloon atrial septostomy or emergency switch operation were more likely to occur in patients who had low neurodevelopmental scores. We conclude that the majority of patients who undergo arterial switch repair demonstrate normal growth and development and no impairment of cardiovascular function. However, significant morbidity in the form of neurodevelopmental problems may occur. (AJDC. 1991;145:40-43) References 1. Gutgesell HP, Garson A, McNamara DG. Prognosis for the newborn with transposition of the great arteries . Am J Cardiol . 1979;44:96-100.Crossref 2. Liebman J, Cullum L, Belloc N. Natural history of transposition of the great arteries: anatomy and birth and death characteristics . Circulation . 1969;40;237-262.Crossref 3. Campbell M. Incidence of cardiac malformations at birth and later, and neonatal mortality . Br Heart J . 1973;35:189-200.Crossref 4. Hallidie-Smith KA. Prostaglandin E, in suspected ductus dependent cardiac malformation . Arch Dis Child . 1984;59:1020-1026.Crossref 5. Freed MD, Heymann MA, Lewis AB, Roehl SL, Kensey RC. Prostaglandin E1 in infants with ductus arteriosus—dependent congenital heart disease . Circulation . 1981;64:899-905.Crossref 6. Lang PL, Freed MD, Bierman FZ, Norwood WI, Nadas AS. Use of prostaglandin E1 in infants with d-transposition of great arteries and an intact ventricular septum . Am J Cardiol . 1979;44:76-81.Crossref 7. Rashkind WJ, Miller WW. Creation of an atrial septal defect without thoracotomy: a palliative approach to complete transposition of the great arteries . JAMA . 1966;196:991-992.Crossref 8. Jatene AD, Fontes VF, Paulista PP, et al. Successful anatomic correction of transposition of the great vessels: a preliminary report . Arg Bras Cardiol . 1975;28:461-464. 9. Castaneda AR, Norwood WI, Jonas RA, Colon SD, Sanders SP, Lang P. Transposition of the great arteries and intact ventricular septum: anatomical repair in the neonate . Ann Thorac Surg . 1984;38:438-443.Crossref 10. Mavroudis C. Anatomical repair of transposition of the great arteries with intact ventricular septum in the neonate: guidelines to avoid complications . Ann Thorac Surg . 1987;43:495-501.Crossref 11. Lecompte Y, Zannini L, Hazan E, et al. Anatomic correction of transposition of the great arteries—new technique without the use of a prosthetic conduit . J Thorac Cardiovasc Surg . 1981;82:629-631. 12. Bayley N. Bayley Scales of Infant Development . New York, NY: The Psychological Corp; 1969. 13. Terman LM, Merrill MA. Stanford-Binet Intelligence Scale . Chicago, Ill: Riverside Publishing Company; 1973. 14. Frankenburg WK, Dodds JB. The Denver Developmental Screening Test . J Pediatr . 1967; 71:181-191.Crossref 15. Senning A. Surgical correction of transposition of the great vessels . Surgery . 1959;45:966-980. 16. Mustard WT. Successful two-stage correction of transposition of the great arteries . Surgery . 1964;55:469-472. 17. Bender HW Jr, Graham TP, Boucek RJ, Walker WE, Boerth RG. Comparative operative results of the Senning and Mustard procedures for transposition of the great arteries . Circulation . 1980;62( (2) pt 2):I197-I203. 18. Trusler GA, Williams WG, Duncan KF. Results of the Mustard operation in simple transposition of the great arteries 1963-1985 . Ann Surg . 1987;206:251-260.Crossref 19. George BL, Laks H, Klitzner TS, Friedman WF, Williams RG. Results of the Senning procedure with simple and complex transposition of the great arteries . Am J Cardiol . 1987;59:426-430.Crossref 20. Trusler GA, Williams WG, Duncan KF, et al. Results with the Mustard operation in simple transposition of the great arteries . Ann Surg . 1987;206:251-260.Crossref 21. Warnes CA, Somerville J. Transposition of the great arteries: late results in adolescents and adults after the Mustard procedure . Br Heart J . 1987;58:148-155.Crossref 22. Norwood WI, Dobell AR, Freed MD, Kirklin JW, Blackstone EH, Congenital Heart Surgeons Society. Intermediate results of the arterial switch repair: a 20-institution study . J Thorac Cardiovasc Surg . 1988;96:854-863. 23. Idriss FS, Ilbawi MN, DeLeon SY, et al. Arterial switch in simple and complex transposition of the great arteries . J Thorac Cardiovasc Surg . 1988;95:29-36. 24. Quaegebeur JM, Rohmer J, Ottenkamp J, Buis T, Kirklin JW, Blackstone EH. The arterial switch operation: an eight-year experience . J Throac Cardiovasc Surg . 1986;92:361-384. 25. Rubay J, de Leval M, Bull C. To switch or not to switch? the Senning alternative . Circulation . 1988;78( (5) pt 5):III1-III4.Crossref 26. Williams WG, Trusler GA, Kirklin JW, et al. Early and late results of a protocol for simple transposition leading to an atrial (Mustard) repair . J Thorac Cardiovasc Surg . 1988;95:717-726. 27. Castaneda AR, Trusler GA, Paul MH, Blackstone EH, Kirklin JW, Congenital Heart Surgeons Society. The early results of treatment of simple transposition in the current era . J Thorac Cardiovasc Surg . 1988;95:14-28. 28. Ferry PC. Neurologic sequelae of cardiac surgery in children . AJDC . 1987;141:309-312. 29. Ehyai A, Fenichel GM, Bender HW Jr. Incidence and prognosis of seizures in infants after cardiac surgery with profound hypothermia and circulatory arrest . JAMA . 1984;252:3165-3167.Crossref 30. Wells FC, Coghill S, Caplan HL, Lincoln C, Kirklin JW. Duration of circulatory arrest does influence the psychological development of children after cardiac operation in early life . J Thorac Cardiovasc Surg . 1983;86:823-831. 31. Newburger JW, Silbert AR, Buckley LP, Fyler DC. Cognitive function and age at repair of transposition of the great arteries in children . N Engl J Med . 1984;310:1495-1499.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Follow-up of Patients Who Underwent Arterial Switch Repair for Transposition of the Great Arteries

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References (36)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1991.02160010042013
Publisher site
See Article on Publisher Site

Abstract

Abstract • Thirty infants underwent arterial switch for transposition of the great arteries within the first week of life (mean age, 2.8 days). An additional three patients underwent repair at 5½, 8, and 9½ months of age. Six (18.2%) of 33 patients died. All the survivors were not receiving cardiac medications or diuretics at the time of the last follow-up visit. Examination of 24 of 27 survivors at 1 to 5 years of age revealed normal growth in 75% of the patients. Two patients had height, weight, and head circumference below the fifth percentile for age. Four patients had height and weight appropriate for age but head circumference below the fifth percentile. Neurodevelopmental testing yielded normal findings in 18 patients. Three patients were considered suspect and an additional three were abnormal neurodevelopmentally. Head circumference less than the fifth percentile, abnormalities on computed tomographic scans of the brain, and emergency balloon atrial septostomy or emergency switch operation were more likely to occur in patients who had low neurodevelopmental scores. We conclude that the majority of patients who undergo arterial switch repair demonstrate normal growth and development and no impairment of cardiovascular function. However, significant morbidity in the form of neurodevelopmental problems may occur. (AJDC. 1991;145:40-43) References 1. Gutgesell HP, Garson A, McNamara DG. Prognosis for the newborn with transposition of the great arteries . Am J Cardiol . 1979;44:96-100.Crossref 2. Liebman J, Cullum L, Belloc N. Natural history of transposition of the great arteries: anatomy and birth and death characteristics . Circulation . 1969;40;237-262.Crossref 3. Campbell M. Incidence of cardiac malformations at birth and later, and neonatal mortality . Br Heart J . 1973;35:189-200.Crossref 4. Hallidie-Smith KA. Prostaglandin E, in suspected ductus dependent cardiac malformation . Arch Dis Child . 1984;59:1020-1026.Crossref 5. Freed MD, Heymann MA, Lewis AB, Roehl SL, Kensey RC. Prostaglandin E1 in infants with ductus arteriosus—dependent congenital heart disease . Circulation . 1981;64:899-905.Crossref 6. Lang PL, Freed MD, Bierman FZ, Norwood WI, Nadas AS. Use of prostaglandin E1 in infants with d-transposition of great arteries and an intact ventricular septum . Am J Cardiol . 1979;44:76-81.Crossref 7. Rashkind WJ, Miller WW. Creation of an atrial septal defect without thoracotomy: a palliative approach to complete transposition of the great arteries . JAMA . 1966;196:991-992.Crossref 8. Jatene AD, Fontes VF, Paulista PP, et al. Successful anatomic correction of transposition of the great vessels: a preliminary report . Arg Bras Cardiol . 1975;28:461-464. 9. Castaneda AR, Norwood WI, Jonas RA, Colon SD, Sanders SP, Lang P. Transposition of the great arteries and intact ventricular septum: anatomical repair in the neonate . Ann Thorac Surg . 1984;38:438-443.Crossref 10. Mavroudis C. Anatomical repair of transposition of the great arteries with intact ventricular septum in the neonate: guidelines to avoid complications . Ann Thorac Surg . 1987;43:495-501.Crossref 11. Lecompte Y, Zannini L, Hazan E, et al. Anatomic correction of transposition of the great arteries—new technique without the use of a prosthetic conduit . J Thorac Cardiovasc Surg . 1981;82:629-631. 12. Bayley N. Bayley Scales of Infant Development . New York, NY: The Psychological Corp; 1969. 13. Terman LM, Merrill MA. Stanford-Binet Intelligence Scale . Chicago, Ill: Riverside Publishing Company; 1973. 14. Frankenburg WK, Dodds JB. The Denver Developmental Screening Test . J Pediatr . 1967; 71:181-191.Crossref 15. Senning A. Surgical correction of transposition of the great vessels . Surgery . 1959;45:966-980. 16. Mustard WT. Successful two-stage correction of transposition of the great arteries . Surgery . 1964;55:469-472. 17. Bender HW Jr, Graham TP, Boucek RJ, Walker WE, Boerth RG. Comparative operative results of the Senning and Mustard procedures for transposition of the great arteries . Circulation . 1980;62( (2) pt 2):I197-I203. 18. Trusler GA, Williams WG, Duncan KF. Results of the Mustard operation in simple transposition of the great arteries 1963-1985 . Ann Surg . 1987;206:251-260.Crossref 19. George BL, Laks H, Klitzner TS, Friedman WF, Williams RG. Results of the Senning procedure with simple and complex transposition of the great arteries . Am J Cardiol . 1987;59:426-430.Crossref 20. Trusler GA, Williams WG, Duncan KF, et al. Results with the Mustard operation in simple transposition of the great arteries . Ann Surg . 1987;206:251-260.Crossref 21. Warnes CA, Somerville J. Transposition of the great arteries: late results in adolescents and adults after the Mustard procedure . Br Heart J . 1987;58:148-155.Crossref 22. Norwood WI, Dobell AR, Freed MD, Kirklin JW, Blackstone EH, Congenital Heart Surgeons Society. Intermediate results of the arterial switch repair: a 20-institution study . J Thorac Cardiovasc Surg . 1988;96:854-863. 23. Idriss FS, Ilbawi MN, DeLeon SY, et al. Arterial switch in simple and complex transposition of the great arteries . J Thorac Cardiovasc Surg . 1988;95:29-36. 24. Quaegebeur JM, Rohmer J, Ottenkamp J, Buis T, Kirklin JW, Blackstone EH. The arterial switch operation: an eight-year experience . J Throac Cardiovasc Surg . 1986;92:361-384. 25. Rubay J, de Leval M, Bull C. To switch or not to switch? the Senning alternative . Circulation . 1988;78( (5) pt 5):III1-III4.Crossref 26. Williams WG, Trusler GA, Kirklin JW, et al. Early and late results of a protocol for simple transposition leading to an atrial (Mustard) repair . J Thorac Cardiovasc Surg . 1988;95:717-726. 27. Castaneda AR, Trusler GA, Paul MH, Blackstone EH, Kirklin JW, Congenital Heart Surgeons Society. The early results of treatment of simple transposition in the current era . J Thorac Cardiovasc Surg . 1988;95:14-28. 28. Ferry PC. Neurologic sequelae of cardiac surgery in children . AJDC . 1987;141:309-312. 29. Ehyai A, Fenichel GM, Bender HW Jr. Incidence and prognosis of seizures in infants after cardiac surgery with profound hypothermia and circulatory arrest . JAMA . 1984;252:3165-3167.Crossref 30. Wells FC, Coghill S, Caplan HL, Lincoln C, Kirklin JW. Duration of circulatory arrest does influence the psychological development of children after cardiac operation in early life . J Thorac Cardiovasc Surg . 1983;86:823-831. 31. Newburger JW, Silbert AR, Buckley LP, Fyler DC. Cognitive function and age at repair of transposition of the great arteries in children . N Engl J Med . 1984;310:1495-1499.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jan 1, 1991

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