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Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years

The surgical management of transposition complex with aortic arch obstruction remains technically demanding due to anatomic complexity. Even in the recent surgical era, there are centers that address this anomaly with a staged strategy. This report presents our experiences with a one-stage repair of...

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Autores principales: Choi, Kwang Ho, Sung, Si Chan, Kim, Hyungtae, Lee, Hyung Doo, Ban, Gil Ho, Kim, Geena, Kim, Hee Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2015
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737791/
https://www.ncbi.nlm.nih.gov/pubmed/26358472
http://dx.doi.org/10.1007/s00246-015-1258-6
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author Choi, Kwang Ho
Sung, Si Chan
Kim, Hyungtae
Lee, Hyung Doo
Ban, Gil Ho
Kim, Geena
Kim, Hee Young
author_facet Choi, Kwang Ho
Sung, Si Chan
Kim, Hyungtae
Lee, Hyung Doo
Ban, Gil Ho
Kim, Geena
Kim, Hee Young
author_sort Choi, Kwang Ho
collection PubMed
description The surgical management of transposition complex with aortic arch obstruction remains technically demanding due to anatomic complexity. Even in the recent surgical era, there are centers that address this anomaly with a staged strategy. This report presents our experiences with a one-stage repair of transposition complexes with aortic arch obstructions more than the last 10 years. Since 2003, 19 patients with a transposition of the great arteries (TGA, 2 patients) or a double outlet of the right ventricle (DORV, 17 patients) and aortic arch obstruction have undergone one-stage repair of their anomalies. The mean age was 6.7 ± 2.3 days, and the mean body weight was 3.4 ± 0.3 kg. The 2 patients with TGA exhibited coarctation of the aorta. The 17 patients with DORV all exhibited the Taussig–Bing type. The great artery relationships were anteroposterior in 4 patients (21.1 %). The coronary artery anatomies were usual (1LCx; 2R) in 8 patients (42.1 %). There were 2 early deaths (10.5 %). Seven patients (36.8 %) required percutaneous interventions. One patient required re-operation for pulmonary valvar stenosis and left pulmonary artery patch angioplasty. The overall survival was 84.2 %. The freedom from mortality was 83.5 % at 5 years, and the freedom from intervention was 54.4 % at 5 years. The one-stage repair of transposition complexes with aortic arch obstructions resulted in an acceptable survival rate and a relatively high incidence of postoperative catheter interventions. Postoperative catheter interventions are highly effective. Transposition complexes combined with aortic arch obstructions can be managed by one-stage repair with good early and midterm results.
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spelling pubmed-47377912016-02-09 Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years Choi, Kwang Ho Sung, Si Chan Kim, Hyungtae Lee, Hyung Doo Ban, Gil Ho Kim, Geena Kim, Hee Young Pediatr Cardiol Original Article The surgical management of transposition complex with aortic arch obstruction remains technically demanding due to anatomic complexity. Even in the recent surgical era, there are centers that address this anomaly with a staged strategy. This report presents our experiences with a one-stage repair of transposition complexes with aortic arch obstructions more than the last 10 years. Since 2003, 19 patients with a transposition of the great arteries (TGA, 2 patients) or a double outlet of the right ventricle (DORV, 17 patients) and aortic arch obstruction have undergone one-stage repair of their anomalies. The mean age was 6.7 ± 2.3 days, and the mean body weight was 3.4 ± 0.3 kg. The 2 patients with TGA exhibited coarctation of the aorta. The 17 patients with DORV all exhibited the Taussig–Bing type. The great artery relationships were anteroposterior in 4 patients (21.1 %). The coronary artery anatomies were usual (1LCx; 2R) in 8 patients (42.1 %). There were 2 early deaths (10.5 %). Seven patients (36.8 %) required percutaneous interventions. One patient required re-operation for pulmonary valvar stenosis and left pulmonary artery patch angioplasty. The overall survival was 84.2 %. The freedom from mortality was 83.5 % at 5 years, and the freedom from intervention was 54.4 % at 5 years. The one-stage repair of transposition complexes with aortic arch obstructions resulted in an acceptable survival rate and a relatively high incidence of postoperative catheter interventions. Postoperative catheter interventions are highly effective. Transposition complexes combined with aortic arch obstructions can be managed by one-stage repair with good early and midterm results. Springer US 2015-09-10 2016 /pmc/articles/PMC4737791/ /pubmed/26358472 http://dx.doi.org/10.1007/s00246-015-1258-6 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Choi, Kwang Ho
Sung, Si Chan
Kim, Hyungtae
Lee, Hyung Doo
Ban, Gil Ho
Kim, Geena
Kim, Hee Young
Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years
title Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years
title_full Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years
title_fullStr Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years
title_full_unstemmed Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years
title_short Transposition Complex with Aortic Arch Obstruction: Outcomes of One-Stage Repair Over 10 Years
title_sort transposition complex with aortic arch obstruction: outcomes of one-stage repair over 10 years
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737791/
https://www.ncbi.nlm.nih.gov/pubmed/26358472
http://dx.doi.org/10.1007/s00246-015-1258-6
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