Follow-up Study after Atrial Switch Operation for Complete Transposition of the Great Arteries

1998 ◽  
Vol 28 (5) ◽  
pp. 683 ◽  
Author(s):  
Youn Woo Kim ◽  
Chung-Il Noh ◽  
June Huh ◽  
Myung-Ja Yun ◽  
Ho-Sung Kim ◽  
...  
Keyword(s):  
Follow Up Study ◽  
Complete Transposition ◽  
Switch Operation ◽  
Atrial Switch ◽  
Atrial Switch Operation

scholarly journals Superior caval venous syndrome after atrial switch procedure: relief of complete venous obstruction by gradual angioplasty and placement of stents

1998 ◽  
Vol 8 (4) ◽  
pp. 443-448 ◽  
Author(s):  
Ina Michel-Behnke ◽  
Karl-Jürgen Hagel ◽  
Jürgen Bauer ◽  
Dietmar Schranz
Keyword(s):  
Guide Wire ◽  
Complete Transposition ◽  
Switch Operation ◽  
Atrial Switch ◽  
Long Term Follow Up ◽  
Intravascular Stents ◽  
Substantial Risk ◽  
Interventional Catheterization ◽  
Atrial Switch Operation

AbstractSuperior caval venous syndrome is one of the late problems known to occur after Mustard repair of complete transposition. Reoperation may leave residual stenosis, and carries substantial risk for the patient. It is now feasible to use intravascular stents to overcome systemic venous baffle obstructions, and such an approach is probably more effective. The purpose of our study therefore, was to assess immediate and medium term results of inserting stents subsequent to gradual balloon enlargement of acquired atresia of the intraatrial baffle in patients who had undergone an atrial switch operation. We investigated five patients with complete obstruction of the superior caval venous pathway at perforation of the atretic segment was achieved using a guide wire technique. The procedure was successful in all patients. Gradual angioplasty was performed and intravascular stents were implanted. The pressure in the superior caval vein dropped to normal values, symptoms improved, and the patency of the newly created venoatrial communication was proven at mid-term follow-up. Thus critical obstructions at the superior caval venous pathway after the Mustard procedure can be reopened by interventional catheterization. Implantation of balloon-expandable intravascular stents is safe and effective in the acute relief of the obstructions, but careful long-term follow-up is mandatory.

Long-term assessment and serial evaluation of cardiorespiratory exercise performance and cardiac function in patients with atrial switch operation for complete transposition

2001 ◽  
Vol 11 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Tony Reybrouck ◽  
Luc Mertens ◽  
Steven Brown ◽  
Benedicte Eyskens ◽  
Willem Daenen ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Cardiac Function ◽  
Exercise Performance ◽  
Complete Transposition ◽  
Ventilatory Anaerobic Threshold ◽  
Switch Operation ◽  
Atrial Switch ◽  
Atrial Switch Operation

AbstractBackground: At present, a considerable number of patients survive who underwent an atrial switch operation for correction of complete transposition. Our study aimed to assess their long-term exercise performance and the serial evolution of cardiac function.Methods: We studied 22 patients 5 to 17 years after an atrial switch operation, and followed them serially for 3.5 ± 2 years after the first evaluation. Cardiorespiratory exercise function was assessed by analysis of gas exhange and by determination of the ventilatory anaerobic threshold. Echocardiography was performed on all evaluations.Results: All patients were in Class I of the classification of the New York Heart Association at all assessments. Ventilatory anaerobic threshold, however, was significantly lower than normal. It averaged 77.9% ± 13.7 of the normal mean value at the initial evaluation, and remained stable when re-evaluated later (76.2 ± 13.7%). At the initial study, the increase in oxygen uptake during graded exercise was below the 95% confidence limit in 6 of the patients, and was below this level in 10 patients at re-assessment. The subnormal values for oxygen uptake during submaximal exercise were associated with moderate to severe haemodynamic dysfunction. At echocardiography, 15 of 17 patients studied twice had mild to moderate right ventricular dilation and tricuspidregurgiation, which remained virtually the same at reasssesment. A stable sinus rhythm was initially present in 17 patients, and persisted in 15 patients during follow-up.Conclusion: At medium term follow-up, cardiorespiratory exercise performance remains stable in patients after atrial switch repair. Serial exercise testing appears useful, because in individual patients in the present study, a decreasing exercise tolerance correlated with development of haemodynamic sequels.

scholarly journals LONG-TERM FOLLOW-UP OF ARTERIAL AND ATRIAL SWITCH OPERATION FOR TRANSPOSITION OF THE GREAT ARTERIES

2013 ◽  
Vol 61 (10) ◽  
pp. E539
Author(s):  
Claudia Junge ◽  
Stephan Schoof ◽  
Mechtild Westhoff-Bleck ◽  
Reiner Buchhorn ◽  
Gerhard Ziemer ◽  
...  
Keyword(s):  
Switch Operation ◽  
Atrial Switch ◽  
Long Term Follow Up ◽  
Atrial Switch Operation

Intermediate-term results of the Senning or Mustard procedures combined with the Rastelli operation for patients with discordant atrioventricular connections associated with discordant ventriculoarterial connections or double outlet right ventricle

2007 ◽  
Vol 17 (2) ◽  
pp. 158-165 ◽  
Author(s):  
Jürgen Hörer ◽  
Felix Haas ◽  
Julie Cleuziou ◽  
Christian Schreiber ◽  
Martin Kostolny ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Systemic Circulation ◽  
Mitral Insufficiency ◽  
Anatomic Repair ◽  
Switch Operation ◽  
Atrial Switch ◽  
Left And Right ◽  
Atrial Switch Operation ◽  
Rastelli Operation

Background:In patients with discordant atrioventricular and ventriculoarterial connections, anatomic repair restores the morphologically left ventricle to its role in supporting the systemic circulation. In this study, we have evaluated the outcomes in the intermediate term for this complex surgical procedure.Methods:Between December 1984 and October 2003, 4 patients underwent an atrial switch operation concomitantly with a Rastelli operation, and 2 patients underwent an atrial switch operation and a patch-plasty of the pulmonary outflow tract for anatomic repair at a mean age of 3.3 plus or minus 2.1 years. All patients had intracardiac rerouting, connecting the morphologically left ventricle to the aorta.Results:There were no hospital deaths. In 5 patients, reoperation was needed, either for baffle complications, exchange of the conduit, repair of a residual ventricular septal defect, or relief of obstruction within the left ventricular outflow tract. Death occurred in 1 patient, from cardiac failure 6 months after correction. Mean follow-up time was 6.5 plus or minus 6.4 years, with a range from 6 months to 17 years. At follow-up, 1 patient presented with moderate tricuspid insufficiency, and 1 patient with mild obstruction of the pulmonary venous pathway. The remaining 3 patients showed good left and right ventricular function, and no, or mild tricuspid and mitral insufficiency.Conclusions:Anatomic repair can be performed with low hospital mortality. Restoration of the morphologically left ventricle into the systemic circulation in patients with discordant atrioventricular and ventriculoarterial connections is a demanding approach, associated with various reoperations over time. Despite this, the approach seems to be an appropriate solution for selected patients, since the majority of the patients show good left and right ventricular function, and no, or mild tricuspid and mitral insufficiency up to 17 years after correction.

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