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James A. Alexander
Daniel G. Knauf
Michael A. Greene
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Ann Thorac Surg 1994;58:1278-1281
© 1994 The Society of Thoracic Surgeons


Articles

The changing strategies in operation for transposition of the great vessels

James A. Alexander, MD, Daniel G. Knauf, MD, Michael A. Greene, MD, L.H.S. van Mierop, MD, Daniel J. O'Brien, PhD*

Division of Thoracic and Cardiovascular Surgery, University of Florida, College of Medicine, Gainesville, Florida, USA

* Address reprint requests to Dr O'Brien, Division of Thoracic and Cardiovascular Surgery, University of Florida, PO Box 100286 JHMHC, Gainesville, FL 32606.

Between July 3, 1985, and February 24, 1994, a total of 55 infants underwent arterial switch procedures for the repair of transposition of the great vessels. Thirty-five infants had an intact ventricular septum and 20 had ventricular septal defects. To date, there have been three late deaths, one in the group with an intact ventricular septum and two in the group with a ventricular septal defect. Early postoperative complications included atrial dysrhythmias, prolonged ventilation, inability to close the sternum, and tension on the coronary arteries. Follow-up echocardiographic data for 44 patients indicate that pulmonary artery gradients are a worrisome postoperative problem, especially in infants who have ventricular septal defects.




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