Late presenters with dextro-transposition of great arteries and intact ventricular septum: to train or not to train the left ventricle for arterial switch operation?

Congenital Heart Disease
Noor Mohamed ParkerGhassan Baslaim

Abstract

We report our experience in managing late presenters (older than 4 weeks) with dextro-transposition of great arteries and intact ventricular septum (d-TGA/IVS) in an effort to achieve successful arterial switch operation (ASO) in a third world setting. We retrospectively reviewed the charts of all late presenters with d-TGA/IVS. Patients were divided into two groups: left ventricular training (LVT) group and non-left ventricular training (non-LVT) group. LVT group underwent pulmonary artery banding and Blalock-Taussig Shunt prior to ASO. Twenty-one late presenters were included in the study. In LVT group, 11 patients with median age of 6 months (range, 1-72 months) underwent LVT. Later, 8 patients with median age of 9.25 months (range, 1.33-84 months) underwent ASO. Prior to ASO, left ventricle (LV) collapse resolved in all and left ventricle to systemic pressure (LV/SP) ratio was 0.81 (range, 0.76-0.95) in 4 patients. Two patients who had LVT for < or =14 days required postoperative extracorporeal membrane oxygenation (ECMO) support due to LV dysfunction. Seven patients survived to discharge. In non-LVT group, 10 patients with median age of 2.5 months (range, 1-98 months) underwent ASO. Five patients had LV collapse, and media...Continue Reading

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Citations

Jul 13, 2011·Current Treatment Options in Cardiovascular Medicine·Paul A Checchia
Aug 29, 2012·The Journal of Thoracic and Cardiovascular Surgery·Gustavo A G FávaroLuiz Felipe P Moreira
Mar 3, 2017·Cardiology in the Young·UNKNOWN Authors/Task Force Members:Pascal R Vouhé
Jan 13, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·George E SarrisPascal R Vouhé
Nov 26, 2020·Asian Cardiovascular & Thoracic Annals·Dicky FakhriArdiansyah Ardiansyah

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