Clinical outcomes of primary arterial switch operation in treatment of Taussig-Bing anomaly

Korun, Oktay

doi:10.5606/tgkdc.dergisi.2017.14159

Cited by 3 publications

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 Genellikle yaşamın ilk ayında yapılan ve Jaten prosedürü olarak da bilinen bu ameliyat, günümüzde BAT'lı olgularda standart cerrahi prosedür hâline gelmiştir. 3,4 İntraoperatif veya erken postoperatif mortalite, hemen her zaman koroner arterlerdeki yetersizlik ile ilişkilidir. 5 Koroner arterlerdeki bükülme, gerilme, anastomozdaki darlık, koroner artere dıştan bası gibi problemler, koroner perfüzyonun kötü olmasına neden olur ki bu da ventrikül fonksiyonunun bozulmasıyla sonuçlanır.…”

unclassified

Comparison of the Results of Open Trap-Door Technique and Closed Coronary Transfer Technique in Arterial Switch Operations: A Retrospective Clinical Study

DOYURGAN¹,

AKDENİZ²,

Kılıç³

et al. 2022

Turkiye Klinikleri J Cardiovasc Sci

View full text Add to dashboard Cite

Arteriyel switch operasyonlarında, koroner translokasyon işleminin doğru yapılması ameliyatın başarısını etkileyen en önemli ögedir. Bu çalışmada, koroner arterlerin transferi için kullanılan 2 farklı translokasyon tekniğinin sonuçlarını karşılaştırdık. Gereç ve Yöntemler: Aralık 2017-Mayıs 2022 tarihleri arasında ardışık 108 hastaya arteriyel switch ameliyatı yapıldı. Hastaların tanıları intakt ventriküler septumlu büyük arter transpozisyonu (BAT) (n=68), ventriküler septal defektli BAT (n=34) ve Taussig-Bing anomalisi (n=6) idi. Yedi hastada aortik arkus anomalisi eşlik ediyordu. Hastaların 70'ine açık trap-door tekniği ile koroner trasfer yapıldı (Grup=1); 38 hastada kapalı koroner transfer metodu uygulandı (Grup=2). Bulgular: Hastaların 86'sı erkek, 22'si kız, medyan yaşı 13 gün ve ortalama vücut ağırlığı 3,3 kg'dı. Gruplar arasında ameliyat esnasındaki vücut ağırlığı, büyük arter ilişkisi ve koroner anomali varlığı bakımından fark yoktu. Tüm hastalar genelinde erken mortalite %12 (n=13) idi. Yirmi altı (%24,1) hastada koroner arter anomalisi saptandı. Koroner arter anomalisi olan hastalarda olmayanlara göre mortalite daha yüksekti (p=0,006). Grup 1 ve Grup 2 arasında komplikasyon ve mortalite bakımından anlamlı fark yoktu. Grup 2'deki hastalarda kros klemp süresi (p=0,009), kardiyopulmoner baypas süresi (p=0,001), yoğun bakımda kalış süresi (p=0,01), hastanede kalış süresi (p=0,001) ve vazoaktif inotrop skoru (p<0,001) Grup 1'deki hastalardan anlamlı olarak daha düşüktü. Takipte Grup 1'de hafif neoaortik kapak yetersizliği oranı Grup 2'den yüksekti (p=0,046). Sonuç: Kapalı teknik daha kısa kros klemp ve kardiyopulmoner baypas zamanı, daha kısa yoğun bakımda ve hastanede kalış süresi, daha düşük vazoaktif inotrop skoru sağlar ve bu teknik postoperatif neoaortik kapak yetersizliği riskini azaltır. Anah tar Ke li me ler: Arteriyel switch ameliyatı; koroner damarlar; reimplantasyon; büyük damarların transpozisyonu ABS TRACT Objective: Correct coronary translocation is the most important factor affecting the success of the operation in arterial switch operations. In this study, we compared the results of 2 different translocation techniques used for the transfer of coronary arteries. Material and Methods: Arterial switch surgery was performed on 108 consecutive patients between December 2017 and May 2022. The diagnoses of the patients were transposition of the great arteries with intact ventricular septum (n=68), transposition of the great arteries with ventricular septal defect (n=34) and Taussig-Bing anomaly (n=6). Aortic arch anomaly was accompanied in 7 patients. Coronary transfer was performed with the open trap-door technique in 70 of the patients (Group=1); closed coronary transfer method was applied in 38 patients (Group=2).Results: Eighty-six of the patients were male, 22 were female, median age was 13 days and mean body weight was 3.3 kg. There was no difference between the groups in terms of operative body weight, great artery relationship and presence of coronary anomaly. Early mortality was 12% (n=13...

show abstract

unclassified

Comparison of the Results of Open Trap-Door Technique and Closed Coronary Transfer Technique in Arterial Switch Operations: A Retrospective Clinical Study

DOYURGAN¹,

AKDENİZ²,

Kılıç³

et al. 2022

Turkiye Klinikleri J Cardiovasc Sci

View full text Add to dashboard Cite

show abstract

The poor long-term outcomes of owl’s eye pulmonary reconstruction technique after arterial switch operation

Dedemoğlu

Korun

Coşkun

et al. 2020

Interactive CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

Abstract OBJECTIVES This study aims to compare the early- and long-term outcomes of patients who undergo owl’s eye pulmonary artery (PA) reconstruction to those of patients who undergo conventional PA reconstruction. METHODS From January 2016 to January 2017, 64 consecutive patients underwent an arterial switch operation. The patients were divided into 2 groups in terms of neo-PA reconstruction method: 30 patients who underwent neo-PA reconstruction by owl’s eye technique were defined as group 1 and 34 patients who underwent neo-PA reconstruction by the conventional approach were defined as group 2. In the final model, after propensity matching, 23 patients from each group with similar propensity scores were included in the study. RESULTS There was no significant difference between the groups regarding patient characteristics and operative findings. In the early period, the duration of intensive care unit and hospital stays and the rate of mild neo-pulmonary stenosis (neo-PS) were significantly higher in the owl’s eye group (P = 0.04, 0.04 and 0.03). In the late period, the rate of severe neo-PS and reintervention was significantly higher in the owl’s eye group (P = 0.02 and 0.04). Furthermore, the rates of 3-year freedom from pulmonary reintervention and freedom from moderate–severe neo-PS were significantly lower in group 1 (P = 0.04). In addition, the owl’s eye reconstruction was the only factor independently related to moderate–severe neo-PS in the long term (hazard ratios = 11.2, P = 0.02). CONCLUSIONS We have abandoned the owl’s eye method for neo-PA reconstruction of the neo-PA because of serious complications. According to our series and the literature, reconstruction of the neo-PA with an oversized, pantaloon-shaped fresh autologous pericardial patch is still superior to the other techniques.

show abstract

Pathogenesis and Surgical Treatment of Dextro-Transposition of the Great Arteries (D-TGA): Part II

Zubrzycki,

Schramm,

Costard-Jäckle

et al. 2024

JCM

View full text Add to dashboard Cite

Dextro-transposition of the great arteries (D-TGA) is the second most common cyanotic heart disease, accounting for 5–7% of all congenital heart defects (CHDs). It is characterized by ventriculoarterial (VA) connection discordance, atrioventricular (AV) concordance, and a parallel relationship with D-TGA. As a result, the pulmonary and systemic circulations are separated [the morphological right ventricle (RV) is connected to the aorta and the morphological left ventricle (LV) is connected to the pulmonary artery]. This anomaly is included in the group of developmental disorders of embryonic heart conotruncal irregularities, and their pathogenesis is multifactorial. The anomaly’s development is influenced by genetic, epigenetic, and environmental factors. It can occur either as an isolated anomaly, or in association with other cardiac defects. The typical concomitant cardiac anomalies that may occur in patients with D-TGA include ventriculoseptal defects, patent ductus arteriosus, left ventricular outflow tract obstruction (LVOTO), mitral and tricuspid valve abnormalities, and coronary artery variations. Correction of the defect during infancy is the preferred treatment for D-TGA. Balloon atrial septostomy (BAS) is necessary prior to the operation. The recommended surgical correction methods include arterial switch operation (ASO) and atrial switch operation (AtrSR), as well as the Rastelli and Nikaidoh procedures. The most common postoperative complications include coronary artery stenosis, neoaortic root dilation, neoaortic insufficiency and neopulmonic stenosis, right ventricular (RV) outflow tract obstruction (RVOTO), left ventricular (LV) dysfunction, arrhythmias, and heart failure. Early diagnosis and treatment of D-TGA is paramount to the prognosis of the patient. Improved surgical techniques have made it possible for patients with D-TGA to survive into adulthood.

show abstract

Clinical outcomes of primary arterial switch operation in treatment of Taussig-Bing anomaly

Cited by 3 publications

References 18 publications

Comparison of the Results of Open Trap-Door Technique and Closed Coronary Transfer Technique in Arterial Switch Operations: A Retrospective Clinical Study

Comparison of the Results of Open Trap-Door Technique and Closed Coronary Transfer Technique in Arterial Switch Operations: A Retrospective Clinical Study

The poor long-term outcomes of owl’s eye pulmonary reconstruction technique after arterial switch operation

Pathogenesis and Surgical Treatment of Dextro-Transposition of the Great Arteries (D-TGA): Part II

Contact Info

Product

Resources

About