Arterial switch in the first hours of life: no need for Rashkind septostomy?

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Timofey NevvazhayNikolay Artemiev

Abstract

We describe our experience of arterial switch operation (ASO) in the first hours of life in children with D-transposition of the great arteries (TGA) intact ventricular septum and restrictive patent foramen ovale (PFO) with severe metabolic disorders. The Rashkind procedure is the usual strategy to stabilize critically ill patient before surgery. We assume that primary ASO is also the safe option. Between 2008 and 2010, 44 neonates underwent ASO. Of these, eight with simple D-TGA had severe acid-base disorders and form the subject of this report. All were operated on within the first 24 h of life. Median time from birth to admission to the hospital was 4 h 52 min. All patients had prenatal diagnoses. In six cases, childbirths were held in a maternity hospital near the heart surgery centre. In two cases, patients were transported from remote hospitals. All patients received prostaglandin E(l), three of them required ventilator support. All patients had small PFO (1-3 mm), oxygen saturation 60-85%. All had metabolic acidosis (pH ranging 6.96-7.2); lactate was increased in all patients (ranging 5.5-17.0 mmol/l). All patients underwent primary ASO. We used normothermic cardiopulmonary bypass (CPB). Median CPB time was 143 min, and ...Continue Reading

References

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Citations

Oct 15, 2013·Heart·Massimiliano CantinottiIsabella Spadoni
Aug 2, 2014·Journal of the American College of Cardiology·Juan VillafañeUNKNOWN American College of Cardiology’s Adult Congenital and Pediatric Cardiology Council
Jun 17, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Arun GopalakrishnanJaganmohan Tharakan
Sep 21, 2016·Chinese Medical Journal·Qing-Yu WuMing-Kui Zhang
Mar 3, 2017·Cardiology in the Young·UNKNOWN Authors/Task Force Members:Pascal R Vouhé
Mar 29, 2014·World Journal for Pediatric & Congenital Heart Surgery·Michael T CainRonald K Woods
Aug 5, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Gil Wernovsky
Jan 13, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·George E SarrisPascal R Vouhé
Feb 6, 2017·The Journal of Obstetrics and Gynaecology Research·Takashi KajiMinoru Irahara

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