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The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 14-28, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
AR Castaneda, GA Trusler, MH Paul, EH Blackstone and JW Kirklin
A total of 187 neonates with simple transposition of the great arteries
(TGA) have been entered into a twenty institution cooperative study between
Jan. 1, 1985, and June 1, 1986. Eighty-two percent entered within the first
2 days of life. Seventy-six of the 187 patients were initially entered into
a treatment protocol leading to an arterial switch repair, 45 into one
leading to an atrial switch (Mustard) repair, and 49 into one leading to a
Senning repair. Five (7%) of the patients entered initially into an
arterial switch protocol later were crossed over to an atrial switch
protocol, and 7% of those entered into an atrial switch (Mustard) protocol
were crossed over to an arterial switch protocol. Formal follow-up
information is available on all patients. Only 5% of patients entered into
an arterial switch protocol were without repair 2 weeks after entry,
whereas 96% and 100%, respectively, of those entered into a Mustard or
Senning atrial switch protocol were without repair at that time.
Ninety-seven percent of the first group had no preliminary procedures other
than balloon atrial septostomy, which was true of only 76% and 90%,
respectively, of the last two groups. No deaths before repair occurred in
the first group, whereas five occurred in the latter two groups (P = 0.06).
Overall survival rate among the 187 patients was 81% at 1 year. The only
risk factors for death were birth weight, date of entry into the study, and
an arterial switch protocol in the group of institutions at high risk for
arterial switch repair; neither an arterial nor an atrial switch protocol
was a risk factor per se. According to the multivariate equation, the
12-month predicted survival rate of a patient with a birth weight of 3.4
kg, entered currently into atrial or arterial switch protocols (except in
the high risk for arterial switch group of institutions) is 92%.
ARTICLES
The early results of treatment of simple transposition in the current era
Children's Hospital Medical Center, Boston, Mass.
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M. Merlo, S. M. De Tommasi, F. Brunelli, P. A. Abbruzzese, G. Crupi, I. Ghidoni, A. Casari, A. Piti, F. Mamprin, and L. Parenzan Long-term results after atrial correction of complete transposition of the great arteries Ann. Thorac. Surg., February 1, 1991; 51(2): 227 - 231. [Abstract] [PDF]
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R. M. Sade Transposition of the Great Arteries Ann. Thorac. Surg., July 1, 1988; 46(1): 116 - 117. [PDF]
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