Arterial switch operation for transposition of great arteries: late results in adult patients

Abstract

<p>Complete transposition of the great arteries (TGA) accounts</p><p>for 5% to 7% of congenital cardiac anomalies, and represents</p><p>the second most common cyanotic heart defect. Successful</p><p>surgery, allowing the majority of patients to survive to</p><p>adulthood, can either involve a physiologic or anatomic</p><p>“correction”. The former (i.e. atrial switch), introduced in</p><p>1958 by Senning and later modified by Mustard, corrects the</p><p>physiologic abnormality of the TGA by creating an atrial baffle</p><p>to direct the venous return to the contralateral atrioventricular</p><p>valve and ventricle. Although mid-term clinical results</p><p>are excellent, this procedure leaves the RV supporting the</p><p>systemic circulation. Hence, complications such as progressive</p><p>RV dysfunction, ensuing tricuspid regurgitation, frequent</p><p>arrhythmias, heart failure and early mortality may arise in the</p><p>long-term<span>5</span>.</p>