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Ann Thorac Surg 1978;25:225-230
© 1978 The Society of Thoracic Surgeons

Articles

Growth after Surgical Repair of Simple D-Transposition of the Great Arteries

Robert J. Levy, M.D.*, Amnon Rosenthal, M.D., Aldo R. Castaneda, M.D., Alexander S. Nadas, M.D.

Departments of Cardiology and Cardiovascular Surgery, The Children's Hospital Medical Center, and the Departments of Pediatrics and Surgery, Harvard Medical School, Boston, MA.

Accepted for publication September 6, 1977.

* Address reprint requests to Dr. Levy, Department of Cardiology, The Children's Hospital Medical Center, 300 Longwood Ave, Boston, MA 02115

The effect of the Mustard procedure on growth was assessed in 45 patients with simple D-transposition of the great arteries (DTGA) surviving for at least one year after operation. Growth failure (below the third percentile for height, weight, or both) was found in 25 of the 45 patients preoperatively and in 8 patients postoperatively.

The principal factors associated with poor growth before repair were advancing age, increased pulmonary and systemic flow, and subpulmonic stenosis. In those patients without postoperative growth failure, growth had returned to the normal range within two years. All patients with retarded growth after the Mustard procedure had had preoperative growth failure as well. In addition, all 8 patients with postoperative growth failure had one or more major residual hemodynamic abnormalities, whereas residual lesions were present in only 10 of the 37 patients with normal postoperative growth.




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