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General Thoracic and Cardiovascular Surgery

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30-12-2022 | Transposition of the Great Artery | Original Article

Comprehensive outcomes after primary arterial switch operation

Authors: Makoto Nakamura, Kazuyoshi Kanno, Masahiko Nishioka

Published in: General Thoracic and Cardiovascular Surgery | Issue 8/2023

Abstract

Objective

To report the long-term outcomes of the arterial switch operation for transposition of the great arteries.

Methods

The data of 35 patients who underwent an arterial switch operation between April 2006 and May 2021 were retrospectively examined; five had double-outlet right ventricles, three had side-by-side transposition, and 27 had d-transposition. The punch-out technique was the basic method for coronary transplantation; however, if coronary artery kinking after additional peeling was a concern, the trap-door technique was used. In aortic reconstruction, the caliber difference between the neoascending aorta and the native pulmonary artery was fixed using the pulmonary artery flap. In pulmonary reconstruction, the pulmonary artery was bilaterally exposed over the second branch.

Results

The median age at operation and follow-up duration were 10.0 (8.0–12.5) days and 72.9 (40.7–139.5) months, respectively. Thirty-four patients survived, and one was lost to follow-up ([coronary transplantation]: right coronary artery, punch-out = 31, trap-door = 2; left coronary artery, punch-out = 28, trap-door = 7; [aortic regurgitation]: no–slight = 27, mild = 6, moderate = 1; [pulmonary regurgitation]: no–slight = 22, mild = 11, moderate = 1). Slight coronary bending occurred in two patients; ischemia was not observed. Catheter stent placement was performed in one of three patients with stenosis at the pulmonary artery bifurcation. Catheter balloon dilation was performed in one patient with supravalvular pulmonary stenosis. There were no cases of coronary, aortic, or pulmonary artery reoperations. The 15-year cumulative reintervention avoidance rate was 91.0%.

Conclusions

There were no deaths or reoperations during the long-term follow-up period, and arterial switch operation outcomes at our hospital were satisfactory.

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Title: Comprehensive outcomes after primary arterial switch operation
Authors: Makoto Nakamura
Kazuyoshi Kanno
Masahiko Nishioka
Publication date: 30-12-2022
Publisher: Springer Nature Singapore
Keyword: Transposition of the Great Artery
Published in: General Thoracic and Cardiovascular Surgery / Issue 8/2023
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-022-01902-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Comprehensive outcomes after primary arterial switch operation

Abstract

Objective

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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