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Repair of Corrected Transposition of the Great Arteries

Journal of the Korean Pediatric Society 2000;43(8):1074-1080.
Published online August 15, 2000.
Repair of Corrected Transposition of the Great Arteries
Soo Jin Kim1, Young Seok Lee1, Mi Young Han1, Jae Young Lee1, Do Jun Jo1, In Seung Park1, Eun Jung Bae1, Chang-Ha Lee2, Woong-Han Kim2, Young-Tak Lee2, Seong Ho Kim3
1Department of Pediatrics, Sejong Heart Institute, Pucheon, Korea
2Department of Cardiac Surgery, Sejong Heart Institute, Pucheon, Korea
3Department of Pediatrics, Gachon Medical School
수정 대혈관 전위의 임상적 고찰
김수진1, 이영석1, 한미영1, 이재영1, 조도준1, 박인승1, 배은정1, 이창하2, 김웅한2, 이영탁2, 김성호3
1부천세종병원 소아과
2부천세종병원 흉부외과
3가천의과대학 소아과학교실
Abstract
Purpose
: To assess the clinical characteristics and surgical approaches in different anatomical and hemodynamic types of corrected transposition of great arteries(TGA) and learn the surgical results of those patients.
Methods
: All 52 patients who were diagnosed as corrected TGA between December 1987 and November 1999 and their medical records were reviewed. Three groups were identified according to associated anomalies; Group 1: TGA with intact ventricular septum(n=7), Group 2: TGA with ventricular septal defect(n=6), Group 3: TGA with ventricular septal defect and pulmonary stenosis(n=39).
Results
: The clinical manifestations and managements according to associated anomalies were different. The average ages at operation were 190, 8.8 and 47 months in Groups 1, 2, and 3, respectively. The five patients underwent double switch operation and the remainder were managed conventionally without correcting discordant connection. Four patients died and 5 patients were re-operated. Eleven patients developed complete heart block, and 7 of them had permanent pacemakers. Progressive systemic tricuspid valve regurgitation developed in 15 patients and progressive systemic right ventricle dysfunction developed in 3 patients.
Conclusion
: The results of conventional management were disappointing, with significant morbidity of tricuspid failure, right ventricle failure and conduction system failure. Anatomical repair of corrected TGA can be achieved with favorable immediate surgical results but long-term follow up will be necessary.
Key Words: Corrected transposition of great arteries


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