Atrial switch procedure in children more than 5 years of age: mid-term results

Abstract

The atrial switch operation using the described technique is low risk, carries acceptable results and is a valuable management option in older patients with d-TGA and a regressed LV.

Mid-Term Outlook Following Modified Senning's Operation for the Correction of Transposition of the Great Arteries: A Case Series and Review of Literature

“…There were no fatalities among our patients, and no re-operations or re-interventions were required. Likewise, Talwar et al [ 7 ] reported nil early or late mortality in patients with TGA, and no one required re-operations during the follow-up period. On the other hand, Maluf [ 9 ] recorded single death (2.5%) in his long-term follow-up.…”

“…Both patients had NYHA class I. Helbing et al [ 20 ], Wells and Blackstone [ 6 ] documented 95%, and Maluf [ 9 ] documented 100% of their TGA patients with NYHA classes I and II during LT follow-up, much similar to our study. Furthermore, Talwar et al [ 7 ] documented that all their SNP group was in NYHA class I post-operatively, had SOS of more than 95% on room air, and all cardiac medications were stopped. In this report, 50% of the patients (case 1) continued their cardiac medications and diuretics, for the duration of their follow-up.…”

“…Among d-TGA patients, the aortic semilunar valve is commonly seen right to the pulmonic valve or the pulmonary valve, among discordant ventriculoarterial and concordant atrio-ventricular connections [ 7 , 8 ]. The left ventricle (LV) of d-TGA patients becomes ineligible for ASO, even though the patient lives beyond five years, limiting the options for surgery to ASO with mechanical LV assist and ASO with LV retraining [ 7 ].…”

“…Among d-TGA patients, the aortic semilunar valve is commonly seen right to the pulmonic valve or the pulmonary valve, among discordant ventriculoarterial and concordant atrio-ventricular connections [ 7 , 8 ]. The left ventricle (LV) of d-TGA patients becomes ineligible for ASO, even though the patient lives beyond five years, limiting the options for surgery to ASO with mechanical LV assist and ASO with LV retraining [ 7 ]. Though there is a good functional outcome and enhanced quality of life (QOL) for TGA patients treated with SO during childhood and adulthood [ 9 ], sudden death due to the risks of using the RV as the systemic ventricle does exist, along with RV dilatation, RV dysfunction, arrhythmias, sinus node dysfunction (SND), baffle leaks (BFLs), and pulmonary pathway and/or systemic pathway obstruction [ 10 ].…”

Medical missions for the provision of paediatric cardiac surgery in low- and middle-income countries

“…51 The visiting surgeon may be faced with defects and complications of longstanding CHD and should be prepared to be flexible and innovative. [52][53][54][55][56] Ultra-fast-track anaesthetic technique is the general goal geared towards early extubation. 57 Normothermic strategies during or post-bypass and use of warm air blowers assist in early extubation.…”