Bigdelian Hamid, Sedighi Mohsen
Department of Cardiovascular Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Cardiovascular Surgery , Chamran Heart Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Tehran Heart Cent. 2020 Jan;15(1):1-5.
The optimal surgical plan to correct the simple transposition of the great arteries (TGA) is the arterial switch operation (ASO). This study aimed to assess the outcomes of ASO in infants with simple TGA with a special focus on the time of surgery. This retrospective study enrolled 105 infants with simple TGA who underwent ASO and categorized them into 3 groups based on the time of repair: first week of life: Group A; second week of life: Group B; and third week of life: Group C. The endpoints, comprised of an assessment of pre- and postoperative outcomes, complications, and survival, were compared between the groups. The mean age of the infants was 10.50±6.26 days, and 61 (58.1%) cases were male. The mean number of days on dopamine was 1.85±0.12 in Group A, 2.48±0.03 in Group B, and 2.67±0.08 in Group C (P<0.001). The mean number of days on epinephrine was 1.25±0.07 in Group B and 1.27±0.08 in Group C (P<0.001). The mean number of days on the ventilator was 3.52±0.20 in Group A, 4.56±0.24 in Group B, and 5.06±0.21 in Group C (P<0.001). The mean number of days of ICU stay was 6.69±0.21 in Group A, 8.46±0.57 in Group B, and 9.70±0.64 in Group C (P<0.001). The infants in Group A had a greater survival rate (97.0%) than those in Group B (94.1%) and Group C (78.4%) (P=0.042). ASO in infants with simple TGA can be done within the first week of life with satisfactory outcomes and survival.
纠正单纯性大动脉转位(TGA)的最佳手术方案是动脉调转术(ASO)。本研究旨在评估ASO治疗单纯性TGA婴儿的疗效,特别关注手术时间。这项回顾性研究纳入了105例行ASO的单纯性TGA婴儿,并根据修复时间将他们分为3组:出生后第一周:A组;出生后第二周:B组;出生后第三周:C组。比较各组之间包括术前和术后结果、并发症及生存率评估在内的终点指标。婴儿的平均年龄为10.50±6.26天,61例(58.1%)为男性。A组多巴胺平均使用天数为1.85±0.12天,B组为2.48±0.03天,C组为2.67±0.08天(P<0.001)。B组肾上腺素平均使用天数为1.25±0.07天,C组为1.27±0.08天(P<0.001)。A组机械通气平均天数为3.52±0.20天,B组为4.56±0.24天,C组为5.06±0.2天(P<0.001)。A组重症监护病房(ICU)平均住院天数为6.69±0.21天,B组为8.46±0.57天,C组为9.70±0.64天(P<0.001)。A组婴儿的生存率(97.0%)高于B组(94.1%)和C组(78.4%)(P=0.042)。单纯性TGA婴儿的ASO可在出生后第一周内进行,疗效和生存率令人满意。