scholarly journals Stambiųjų kraujagyslių transpozicija ir arterijų sukeitimo operacijos: mūsų patirtis

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Kęstutis Lankutis ◽  
Virgilijus Lebetkevičius ◽  
Virgilijus Tarutis ◽  
Vidmantas Žilinskas ◽  
Sigitas Čibiras ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Arterial Switch Operation ◽  
Pulmonary Stenosis ◽  
Double Outlet Right Ventricle ◽  
University Hospital ◽  
Mortality And Morbidity ◽  
Arterial Switch ◽  
Switch Operation ◽  
Vilnius University ◽  
Underlying Pathology

Kęstutis Lankutis1, Virgilijus Lebetkevičius2, Virgilijus Tarutis2, Vidmantas Žilinskas2, Sigitas Čibiras2, Rita Sudikienė1, Daina Liekienė2, Vytautas Sirvydis21 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Įvadas / tikslas Straipsnyje apžvelgiama mūsų techniškai sunkios arterijų sukeitimo operacijos (Jatene) ir stambiųjų kraujagyslių transpozicijos vaikams patirtis. Ligoniai ir metodai Retrospektyviai nagrinėjami 48 ligoniai, kuriems mūsų centre buvo atlikta arterijų sukeitimo operacija. Daugeliu atvejų – tai d-transpozicija ir keturiais atvejais buvo dvigubas ištekėjimas iš dešiniojo skilvelio ir transpozicija (Taussig-Bing tipas). Operacijos atliktos naudojant dirbtinę kraujotaką, kartu atlikta anatomiškai radikali ydos korekcija. Rezultatai Nuo 2002 m. sausio mėn. iki 2007 m. kovo mėn. operuoti 27 kūdikiai. Šiuo laikotarpiu, išmokus operacijos technikos, taikyta standartinė operacijos metodika. Operacinis šios grupės mirtingumas 11%. Dažniausia mirties priežastis – miokardo išemija dėl nesėkmingos vainikinių arterijų perkėlimo procedūros, esant nepalankiai anatominei jų padėčiai. Dėl pooperacinių vėlyvųjų komplikacijų stebėti keturi ligoniai, kuriems buvo įvairaus laipsnio plaučių arterijos stenozė. Du ligoniai dėl šios komplikacijos operuoti. Išvados Arterijų sukeitimo operacijos kaip fiziologiškiausios yra pirmo pasirinkimo vaikams, kuriems yra stambiųjų kraujagyslių transpozicija. Pastaraisiais metais pasiekta gana gerų ir priimtinų mirtingumo ir kokybės rodiklių. Pagrindiniai žodžiai: arterijų sukeitimo operacija, Jatene operacija, pagrindinių arterijų transpozicija Our experience in arterial switch operation of the great arteries Kęstutis Lankutis1, Virgilijus Lebetkevičius2, Virgilijus Tarutis2, Vidmantas Žilinskas2, Sigitas Čibiras2, Rita Sudikienė1, Daina Liekienė2, Vytautas Sirvydis21 Cardiac Surgery Centre of Vilnius University Hospital „Santariškių klinikos“,Santariškių str. 2, LT-08661 Vilnius2 Cardiac Surgery Centre, Vilnius University, Santariškių str. 2, LT-08661 VilniusE-mail: [email protected] Background / objective A review of our experience in the technically demanding arterial switch operation (Jatene) in transposition of the great arteries in children. Patients and methods 48 children who underwent an arterial switch operation at our Centre were retrospectively reviewed. The underlying pathology was d-transposition of the great arteries and a double outlet right ventricle of Taussig-Bing transposition type in four cases. The operation was performed in cardiopulmonary bypass for anatomically repair of the transposition. Results From January 2002 – March 2007, 27 infants underwent an arterial switch operation. Operative mortality in this period was 11%, in most cases from myocardial ischemia following unsuccessful transfer of a dangerous pattern of coronary arteries. Postoperative morbidity occurred in four patients who presented various degrees of pulmonary stenosis artery. Two patients required reoperation. Conclusions The arterial switch operation is considered to be a procedure of choice for correction of transposition of the great arteries. The operation involves acceptable mortality and morbidity. Key words: arterial switch operation, Jatene operation, transposition of the great arteries

Primary Intracardiac Repair of Double Outlet Right Ventricle and Ventricular Septal Defect without Pulmonary Stenosis

1995 ◽  
Vol 3 (3-4) ◽  
pp. 103-108
Author(s):  
KG Jaya Prasanna ◽  
Krishna Subramony Iyer ◽  
Rajesh Sharma ◽  
Balram Airan ◽  
Ivatury Mrityonjaya Rao ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Arterial Switch Operation ◽  
Pulmonary Stenosis ◽  
Double Outlet Right Ventricle ◽  
Arterial Switch ◽  
Intracardiac Repair ◽  
Switch Operation

From January 1991' to May 1994, 29 patients with double outlet right ventricle with ventricular septal defect, without pulmonary stenosis underwent primary intracardiac repair at the All India Institute of Medical Sciences, New Delhi. Patients were classified into 4 groups based on location of the ventricular septal defect. The ventricular septal defect was subaortic in 11, subpulmonary in 13, doubly committed subarterial in 1, and noncommitted in 4 patients. Surgical treatment consisted of intraventricular routing of the left ventricle to the aorta (17), and the left ventricle to the pulmonary artery followed by an arterial switch operation (12). There were 4 (13.9%) early deaths. Follow-up ranged from 3 months to 3 years (mean, 1.5 years). There was no late mortality. Three patients had residual ventricular septal defect, one of whom has undergone reoperation. One patient has a gradient of 25 mmHg across the left ventricular outflow tract. Double outlet right ventricle with subpulmonic ventricular septal defect was found to be a significant risk factor for early mortality (p = 0.03). The subgroup of double outlet right ventricle with subpulmonic ventricular septal defect who had a combination of single coronary artery and post arterial switch operation was particularly prone to pulmonary hypertensive crisis and hospital death (p = 0.002).

scholarly journals Is arterial switch operation possible with neonatology-focused intensive care unit modality

2021 ◽  
Vol 29 (2) ◽  
pp. 136-142
Author(s):  
Onur Doyurgan ◽  
Fatih Özdemir ◽  
Osman Akdeniz ◽  
Ahmet Kuddusi İrdem ◽  
Nilüfer Matur Okur ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Arterial Switch Operation ◽  
Length Of Hospital Stay ◽  
Morbidity Rate ◽  
Median Length ◽  
Mortality And Morbidity ◽  
Arterial Switch ◽  
Switch Operation

Background: In this study, we aimed to examine the feasibility of arterial switch operation and its perioperative management with neonatology-focused intensive care modality in a region of Turkey where the birth rate and the number of asylum seekers who had to leave their country due to regional conflicts are high. Methods: Between December 2017 and June 2020, a total of 57 patients (48 males, 9 females; median age: 12.2 days; range, 2 to 50 days) who were diagnosed with transposition of the great arteries in our clinic and underwent arterial switch operation were retrospectively analyzed. All patients were followed by the neonatologist in the neonatal intensive care unit during the preoperative and postoperative period. Results: Thirty-eight (66.7%) patients had intact ventricular septum, 16 (28.1%) had ventricular septal defect, two (3.5%) had coarctation of the aorta, and one (1.7%) had Taussig-Bing anomaly. Coronary artery anomaly was present in 14 (24.5%) patients. The most common complications in the intensive care unit were renal failure requiring peritoneal dialysis in seven (12.3%) patients, supraventricular tachyarrhythmia in six (10.5%) patients, and eight (14%) patients left their chests open. The median length of stay in intensive care unit was 13.8 (range, 9 to 25) days and the median length of hospital stay was 24.5 (range, 16 to 47) days. The overall mortality rate for all patients was 12.3% (n=7). The median follow-up was 8.2 months. A pulmonary valve peak Doppler gradient of ≥36 mmHg was detected in five patients (8.7%) who were followed, and these patients were monitored by providing medical treatment. None of the patients needed reoperation or reintervention. Conclusion: We believe that arterial switch operation, one of the complex neonatal cardiac surgery, can be performed with an acceptable mortality and morbidity rate with the use of neonatology-focused intensive care modality, which is supported by pediatric cardiology and pediatric cardiac surgery.

scholarly journals Vieno etapo Taussig ir Bingo anomalijos esant aortos koarktacijai ir aortos lanko hipoplazijai korekcija kūdikiui

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Virgilijus Tarutis ◽  
Virgilijus Lebetkevičius ◽  
Kęstutis Versockas ◽  
Kęstutis Lankutis ◽  
Rita Sudikienė ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Aortic Arch ◽  
Arterial Switch Operation ◽  
Intensive Therapy ◽  
Left Ventricular ◽  
University Hospital ◽  
Switch Operation ◽  
Left Ventricular Reconstruction ◽  
Vilnius University ◽  
Hypoplastic Aortic Arch

Virgilijus Tarutis1, Virgilijus Lebetkevičius1, Kęstutis Versockas2, Kęstutis Lankutis3, Rita Sudikienė3, Daina Liekienė1, Virginijus Jakutis2, Žydrė Jurgelienė2, Asta Bliūdžiūtė2, Solveiga Umbrasaitė2, Vidmantas Žilinskas1, Vytautas Sirvydis11 Vilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikos, Anesteziologijos,intensyviosios terapijos ir skausmo gydymo centras, Santariškių g. 2, LT-08661 Vilnius3 Vilniaus universiteto ligoninės Santariškių klinikos Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Straipsnyje pasakojame apie kompleksinės Taussig ir Bingo anomalijos esant aortos koarktacijai ir hipoplastiškam aortos lankui vienmomentį chirurginį gydymą, pirmąkart atliktą Lietuvoje.2007 m. vasario 8 d. Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centre operuotas 2 mėnesių 4,2 kg svorio kūdikis, kurio klinikinė diagnozė buvo: dvigubas ištekėjimas iš dešiniojo skilvelio, Taussig ir Bingo anomalija, skilvelių pertvaros defektas, aortos koarktacija ir aortos lanko hipoplazija, plautinė hipertenzija, lėtinė hipoksemija, lėtinis širdies nepakankamumas. Atlikta vienmomentė ištaisanti visas ydas chirurginė korekcija – aortos koarktacijos ir hipoplastiško aortos lanko plastika, stambiųjų arterijų apkeitimo (Jatene) operacija ir skilvelių pertvaros defekto plastika. Operacija pavyko sėkmingai, kūdikis išleistas į namus stabilios būklės 26 parą po operacijos. Pagrindiniai žodžiai: dvigubas ištekėjimas iš dešiniojo skilvelio, Taussig ir Bingo anomalija, aortos lanko hipoplazija, Jatene operacija Left ventricular reconstruction: preoperative and operative risk factors Virgilijus Tarutis1, Virgilijus Lebetkevičius1, Kęstutis Versockas2, Kęstutis Lankutis3, Rita Sudikienė3, Daina Liekienė1, Virginijus Jakutis2, Žydrė Jurgelienė2, Asta Bliūdžiūtė2, Solveiga Umbrasaitė2, Vidmantas Žilinskas1, Vytautas Sirvydis11 Vilnius University, Cardiac Surgery Centre, Santariškių str. 2, LT-08661 Vilnius, Lithuania2 Vilnius University Hospital „Santariškių klinikos“, Centre of Anaesthesiology,Intensive Therapy and Pain Management, Santariškių str. 2, LT-08661 Vilnius, Lithuania3 Vilnius University Hospital „Santariškių klinikos“,Cardiac Surgery Centre,Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] We report a case of a successful one-stage repair of Taussig–Bing anomaly with aortic coarctation and hypoplastic aortic arch in a 2-month-old infant. It was the first surgical correction of this type in Lithuania. The patch augmentation of the aortic arch and ascending aorta, arterial switch operation and ventricular septal defect patch closure were accomplished as a switch operation. Key words: double outlet right ventricle, Taussig–Bing anomaly, hypoplastic aortic arch

Does a prenatal diagnosis affect mortality and morbidity for neonatal arterial switch operation

2022 ◽  
pp. 1-5
Author(s):  
Osman Guvenc ◽  
Serdar Beken ◽  
Aysegul Inamlik ◽  
Eda Albayrak ◽  
Bahar Temur ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Arterial Switch Operation ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Arterial Switch ◽  
Switch Operation ◽  
Neonatal Icu ◽  
Group 1

Abstract Background: The effect of prenatal diagnosis on prognosis in patients with transposition of the great arteries is not clear. In this study, we compared the outcomes after arterial switch operation. Methods: Outcome of 112 patients who had arterial switch operation in the neonatal period were analysed. The patients were divided into two groups: those who had prenatal diagnosis (Group 1; n = 34) and those who did not (Group 2; n = 78). The patients were also classified based on their diagnosis: simple transposition, transposition with ventricular septal defect and/or aortic arch hypoplasia, and Taussig–Bing anomaly. Results: In Group 1, the C-section delivery rate was higher (82% vs. 44%; p = 0.004), and it was observed that patients in Group 1 were more often intubated upon admission to the neonatal ICU (38% vs. 9%; p = 0.005). No differences were found between the two groups in terms of operation time, cardiopulmonary bypass time, post-operative invasive respiratory support duration, or extracorporeal membrane oxygenation support. It was observed that those who had Taussig–Bing anomaly had a higher mortality. Conclusions: Timely treatment have a positive effect on neonatal mortality and morbidity. That’s why all families with prenatal diagnosis of critical CHD should be recommended to have the delivery in a tertiary care hospital. Although it could not be demonstrated in this study, prenatal diagnosis has a potential to improve surgical results especially in countries or cities, which does not have enough resources for transfer and surgical units. Further efforts are needed to improve prenatal screening programmes.

Biventricular Repair of Double Outlet Right Ventricle: Preoperative Echocardiography and Surgical Outcomes

2017 ◽  
Vol 8 (3) ◽  
pp. 354-360 ◽  
Author(s):  
Hong Meng ◽  
Kun-Jing Pang ◽  
Shou-Jun Li ◽  
David Hsi ◽  
Jun Yan ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Arterial Switch Operation ◽  
Double Outlet Right Ventricle ◽  
Double Root ◽  
Biventricular Repair ◽  
Arterial Switch ◽  
Switch Operation ◽  
Hospital Deaths ◽  
Selection Of

Objective: To discuss the key anatomic features of double outlet right ventricle (DORV) assessed by preoperative echocardiography among patients treated with different types of biventricular repair. Methods: Surgical and echocardiographic databases were queried to identify patients who had undergone biventricular repair for DORV and had adequate preoperative echocardiographic imaging. All patients underwent pre- and postoperative echocardiography and clinical evaluation following discharge. Results: Two hundred sixty-two patients with DORV met the inclusion criteria of the study. The patients were divided into two groups—intraventricular tunnel repair (IVR) to the aorta (194 [74%] patients) or to the pulmonary artery with either concomitant arterial switch operation or double-root translocation (68 [26%] patients). Among 68 patients undergoing IVR to the pulmonary artery, 50 patients with transposition of the great arteries (TGA) type of DORV and 7 patients with remote ventricular septal defect (VSD) type underwent IVR plus arterial switch operation and 6 patients with TGA type and 5 patients with remote VSD type underwent IVR plus double-root translocation. There were three hospital deaths and one late death (overall operative mortality: 1.5%). Conclusion: Preoperative echocardiography provided crucial data to estimate the feasibility of intraventricular tunnel creation to either the aorta or the pulmonary artery and to guide the selection of either arterial switch or double-root translocation. Biventricular repair could be achieved with favorable outcomes in most patients with DORV.

scholarly journals Intervention for Supravalvar Pulmonary Stenosis After the Arterial Switch Operation

2016 ◽  
Vol 102 (1) ◽  
pp. 154-162 ◽  
Author(s):  
Joseph R. Nellis ◽  
Joseph W. Turek ◽  
Osamah T. Aldoss ◽  
Dianne L. Atkins ◽  
Benton Y. Ng
Keyword(s):  
Arterial Switch Operation ◽  
Pulmonary Stenosis ◽  
Arterial Switch ◽  
Switch Operation

scholarly journals Pulmonary stenosis after arterial switch operation for complete transposition of the great arteries(TGA).

1989 ◽  
Vol 19 (1) ◽  
pp. 7-12
Author(s):  
Tadashi IKEDA ◽  
Yoshio YOKOTA ◽  
Fumio OKAMOTO ◽  
Akira SHIMIZU ◽  
Shogo NAKAYAMA ◽  
...  
Keyword(s):  
Arterial Switch Operation ◽  
Pulmonary Stenosis ◽  
Arterial Switch ◽  
Complete Transposition ◽  
Switch Operation

scholarly journals Case Report: Favoring biventricular repair beyond the conventional boundaries with primary arterial switch operation in a young adult

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 507
Author(s):  
Sumit Agasty ◽  
Sangdup Tsering ◽  
P Ramesh Menon ◽  
Sandeep Chauhan ◽  
Akshay Kumar Bisoi
Keyword(s):  
Septal Defect ◽  
Arterial Switch Operation ◽  
Pulmonary Stenosis ◽  
Biventricular Repair ◽  
Transposition Of Great Arteries ◽  
Arterial Switch ◽  
Post Operative Period ◽  
Switch Operation ◽  
Two Stages ◽  
Adult Male Patient

Transposition of great arteries (TGA) presents in neonates or in infancy. We report a case of TGA with ventricular septal defect (VSD) and pulmonary stenosis (PS) in an adult male patient of 23 years age. Arterial switch operation with VSD closure and neo-aortic valve replacement was done. The patient recovered well in the post-operative period. In adult patients, conversion from atrial to arterial switch has been widely reported, both directly and after prior pulmonary artery banding in two stages, but primary arterial switch for TGA has not been reported previously. In this patient there was a benefit of having a large VSD and severe PS.

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