Clinical Analysis Of Switch Operation For Complete Transposition Of Great Arteries

Objective: To summarize our hospital for treatment efficacy in childrenSwitch complete transposition of great arteries, retrospective analysis ofthe relationship between the efficacy of surgery and surgical age, riskfactors for death, improving the level of hospital clinical diagnosis of thedisease and improve survival.Materials and Methods: There57children were diagnosed in ourhospitalized，hospitalized parallel data switch operation for completetransposition of great arteries from March2003to February2014period.48males,9females, age at surgery3days to6years,10months (mean136.9±352.4d), surgical weight2.6-20Kg (mean4.6±2.8). Depending onwhether the merger VSD divided into two groups, IVS Group: intactventricular septum, VSD group: ventricular septal defect. Will be dividedaccording to age group IVS IVS/eraly (≤14d), IVS/late (>14d) twosubgroups; VSD group was divided into VSD/eraly (≤28d), VSD/late(>28d) two subgroups. CPB time within the two groups were comparedfor all ages, aortic clamping time, postoperative ICU treatment time, postoperative mechanical ventilation time, special treatment, postoperativecomplications (low cardiac output syndrome, renal failure, secondarydifferences surgery, etc.). Simultaneous analysis of survival and death inchildren with body weight in children surgery, preoperative pneumonia,accompanied by VSD, CPB time, blocking the AAO time, coronaryabnormalities, the difference between the special treatment andcomplications.RESULTS: There were24deaths, two cases gave up treatment anddischarged, the overall mortality rate was42%, the mortality ratedecreased year by year, for the past two years, the mortality rate13%,TGA/IVS, between TGA/VSD group had no significant mortalitydifferences. IVS/early, CPB time, AAO time, after special treatment,complications difference between IVS/late groups were not statisticallysignificant (P>0.05); CPB death among children with VSD/early, VSD/late group time, blocking the AAO time, after special treatment,complications, postoperative differences were not statistically significant(P>0.05). Death and survival in children group of children group CPBtime, AAO time, postoperative low cardiac output syndrome wassignificantly (P <0.05). After review of UCG shows aortic regurgitationoccurred in VSD/late group.Conclusion:1.Age is not a decisive factor affecting the efficacy of surgical Switch; preoperative comprehensive assessment of TGA/IVS children with leftventricular function, TGA/VSD children with pulmonary arterialpressure, the child is older TGA a radical premise.2.CPB, AAO long time, postoperative low cardiac output syndrome inchildren with TGA is a radical prognostic risk factors.3. Switch operation in our hospital mortality rate is still high, with theaccumulation of surgeon experience and improved postoperative caretechnology, yearly mortality rate has decreased significantly in recent yearswas13%.