Xu Zhi-wei, Liu Jin-fen, Zhang Hai-bo, Zheng Jing-hao, Yan Qin, Qiu Li-sheng, Wang Shun-ming, Su Zhao-kang, Ding Wen-xiang
Department of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University, Shanghai 200127, China.
Zhonghua Wai Ke Za Zhi. 2007 Jun 15;45(12):801-4.
To review and analysis the surgical results of 113 arteries Switch operations.
One hundred and thirteen patients had been repaired by arterial Switch operation from January 2001 to December 2005. There were 60 patients with transposition of the great arteries and intact ventricular septum (TGA/IVS), 53 patients with transposition of great arteries and ventricular septal defect (TGA/VSD). The lowest body weight was 2.3 kg, and the youngest operative age was 6 h. The arteries Switch operation was performed underwent deep hypothermic circulation arrest and low-flow perfusion.
The total mortality was 9.7%. There were 5 deaths among TGA/IVS (8.3%), 6 deaths among TGA/VSD (11.3%). Following improvement of surgical technique, post-operative management and cardiopulmonary bypass, the operative mortality was decreased from 16.6% to 5.5%.
The main reason for operative mortality was abnormal coronary arteries. The incidence of abnormal coronary arteries was high at TGA/VSD. The surgical results was not infected by the position of great arteries. The low cardiac output was appeared if the ratio of left ventricular pressure and right ventricular pressure less than 0.6.
回顾并分析113例动脉调转手术的手术结果。
2001年1月至2005年12月期间，113例患者接受了动脉调转手术修复。其中，60例为大动脉转位合并室间隔完整（TGA/IVS），53例为大动脉转位合并室间隔缺损（TGA/VSD）。最低体重为2.3千克，最小手术年龄为6小时。动脉调转手术在深低温停循环和低流量灌注下进行。
总死亡率为9.7%。TGA/IVS中有5例死亡（8.3%），TGA/VSD中有6例死亡（11.3%）。随着手术技术、术后管理和体外循环的改进，手术死亡率从16.6%降至5.5%。
手术死亡的主要原因是冠状动脉异常。TGA/VSD中冠状动脉异常的发生率较高。手术结果不受大动脉位置的影响。如果左心室压力与右心室压力之比小于0.6，则会出现低心输出量。
