Görler Heidi, Ono Masamichi, Thies Arne, Lunkewitz Esther, Westhoff-Bleck Mechthild, Haverich Axel, Breymann Thomas, Boethig Dietmar
Division of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Interact Cardiovasc Thorac Surg. 2011 Apr;12(4):569-74. doi: 10.1510/icvts.2010.253898. Epub 2011 Jan 12.
Since a growing number of patients after surgical repair of transposition of the great arteries (TGA) survive until adulthood the focus of attention has shifted to the management of associated long-term morbidity and quality of life (QoL). Therefore, we reviewed all patients that underwent surgical repair of TGA at our institution and compared long-term results after atrial and arterial switch operation. Between 1973 and 2000, a total of 302 patients underwent either atrial switch operation (n=222) or arterial switch operation (n=80). Mean follow-up was 14.5±10.1 years. The arterial switch repair was associated with a higher early mortality whereas long-term survival was comparable between both groups. Postoperative arrhythmias including loss of sinus rhythm and pacemaker implantation occurred significantly more often after atrial switch repair. There was a trend towards a more favourable outcome of the arterial switch group concerning freedom from re-interventions, severe systemic ventricular dysfunction and need for heart failure medication. However, also the arterial switch operation was associated with an increased incidence of loss of sinus rhythm and neo-aortic valve regurgitation during late follow-up. Health related QoL according to the SF-36 questionnaire was not significantly different between both groups and comparable to a healthy population.
由于越来越多的大动脉转位（TGA）手术修复后的患者存活至成年，关注焦点已转向相关长期疾病的管理和生活质量（QoL）。因此，我们回顾了在我们机构接受TGA手术修复的所有患者，并比较了心房和动脉调转手术后的长期结果。1973年至2000年间，共有302例患者接受了心房调转手术（n = 222）或动脉调转手术（n = 80）。平均随访时间为14.5±10.1年。动脉调转修复与较高的早期死亡率相关，而两组的长期生存率相当。心房调转修复后，包括窦性心律丧失和起搏器植入在内的术后心律失常发生率明显更高。在免于再次干预、严重的体循环心室功能障碍和心力衰竭药物需求方面，动脉调转组有取得更有利结果的趋势。然而，在晚期随访期间，动脉调转手术也与窦性心律丧失和新主动脉瓣反流的发生率增加有关。根据SF - 36问卷评估的与健康相关的生活质量在两组之间无显著差异，且与健康人群相当。
