HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Richard G. Ohye Eric J. Devaney Jennifer C. Hirsch Edward L. Bove Permission Requests Google Scholar Articles by Gaies, M. G. Articles by Bove, E. L. PubMed Articles by Gaies, M. G. Articles by Bove, E. L. Related Collections Congenital - cyanotic

---

Original Articles: Pediatric Cardiac

Early and Intermediate Outcome After Anatomic Repair of Congenitally Corrected Transposition of the Great Arteries

^a Department of Pediatrics, University of Michigan School of Medicine, Ann Arbor, Michigan
^b Division of Pediatric Cardiac Surgery, Department of Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan

Accepted for publication August 7, 2009.

^_* Address correspondence to Dr Gaies, L1242 Women's, SPC 5204 1500 E Medical Center Dr, Ann Arbor, MI 48109-5204 (Email: mgaies{at}med.umich.edu).

Background: Anatomic repair of congenitally corrected transposition of the great arteries has become a useful surgical strategy with potential advantages over conventional surgical repair. We describe early and intermediate outcomes after anatomic repair and analyze potential risk factors influencing these outcomes.

Methods: A retrospective review was performed on all patients undergoing anatomic repair between January 1993 and January 2009. The primary outcome was in-hospital mortality. Variables potentially associated with outcome were identified a priori. Bivariate analyses were performed to determine the association between these variables and all outcome measures.

Results: In 65 patients who underwent anatomic repair, 35 had Senning/arterial switch and 30 had Senning/Rastelli. Early and intermediate survival rates for Senning/arterial switch operations were 94% and 91%, respectively. Repairs were successful in patients with tricuspid regurgitation, left ventricular outflow obstruction, and left ventricular dysfunction. Predictors of outcome were not identified in this subset. Early and intermediate survival rates for Senning/Rastelli operations were 77% and 60%, respectively. Longer aortic cross-clamp (p = 0.03) and cardiopulmonary bypass times (p = 0.01) were associated with mortality. Ventricular septal defect enlargement was associated with surgical heart block (p < 0.01). Age, prior procedures, atrial-apical discordance, and tricuspid regurgitation were not associated with outcome.

Conclusions: Senning/arterial switch operations can be performed with excellent intermediate-term outcomes in patients with lesions previously thought to confer higher risk. Candidates for Senning/Rastelli procedures may be at increased risk for postoperative morbidity and mortality. More data are necessary to determine factors influencing outcome after anatomic repair.