Avtor/Urednik		Hraška, Viktor; Sojak, Vladimir; Kaldararova, Monika; Siman, Jaroslav; Mašura, Jozef; Krevs, Nedeljko; Mazić, Uroš; Vesel, Samo; Gaber, Brane; Podnar, Tomaž
Naslov		Results of anatomic correction of transposition of the great arteries in Slovakia and Slovenia
Prevedeni naslov		Rezultati anatomske korekcije transpozicije velikih arterij na Slovaškem in v Sloveniji
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 69, št. 7-8
Leto izdaje		2000
Obseg		str. 495-8
Jezik		eng
Abstrakt		Background. Due to the risk of failure of the systemic morphologic right ventricle after the physiological correction of transposition of the great arteries, anatomic repairs is a method of choice. The purpose of the present study was to analyse the results of anatomic correction of transposition of the great arteries in a single institution. Methods. Between October 1993 and June 1999, 99 patients with transposition of the great arteries without pulmonary stenosis underwent anatomic correction. Seven/six patients had transposition with an intact interventricular septum and twenty-three patients had transposition with ventricular septal defects. The mean age at operation was 15.3 days (+-20.9 days and mean weight 3423g (+-449g). Results. Overall hospital mortality was 7% (7 patients). The 1, 2,3,4,5 and 6 year survival rate was 93% with mean followup of 2.6 years. There was no late mortality. Patients operated on during, or after 1997 had a significantly (P=0.0387) better survival rate compared to patients undergoing oparetion before 1997. Overall mortality was only 2% (1 patient) among 52 consecutive patients operated on between 1997 and 1999. All patients are in NYHA functional class I, without medication and with a normal left ventricular function. Pulmonary stenosis (gradient > 30 torr) was noted in 2 patients (2.0%). More than mild neoaortic regurgitation was noted anly in 1 patient (1.0%). Conclusions. Encouraging early and intermediate-term clinical outcomes were obtained in neonates with transposition of the great arterial switch operation. The left ventricle becomes a systemic ventricle, which is essential in view of the long-term performance. Background. Transposition of the great arteries (D-TGA) is a congenital heart defect with concordant atrio-ventricular and discordant heart defect with concordant atrio-ventricular and discordant ventriculo-arterial connections. (Abstract truncated at 2000 characters.)
Izvleček		Izhodišča. Zaradi rizika odpovedi sistemskega morfološko desnega ventrikla po fiziološki korekciji transpozicije velikih arterij je metoda izbora anatomska korekcija. Namen študije je analiza rezultatov anatomske korekcije transpozicije velikih arterij v eni ustanovi. Metode. Med oktobrom 1993 in junijem 1999 je bila pri 99 bolnikih izvedena anatomska korekcija transpozicije velikih arterij brez pulmonalne stenoze. Šestinsedemdeset bolnikov je imelo transpozicijo velikih arterij z intaktnim interventrikularnim septumom, triindvajset pa s pridruženim defektom interventrikularnega septuma. Povprečna starost v času operacije je bila 15,3 dneva (+- 20,9) in povprečna teža 3.423 gramov (+- 449). Rezultati. Skupna hospitalna smrtnost je bila 7% (7 pacientov). Eno-, dvo-, tro-, štiri-, pet-, in šestletno preživetje je bilo 93% ob povprečnem 2,6-letnem trajanju sledenja. Kasne smrtnosti ni bilo. Bolniki, operirani v in po letu 1997, so imeli signifikantno boljše preživetje (P=0,0387) kot bolniki operirani pred letom 1997. Med letoma 1997 in 1999 je bila celotna smrtnost samo 2% (1 bolnik od 52 zaporedno operiranih bolnikov). Vsi bolniki so v funkcionalnem razredu 1 po NYHA, brez zdravil in z normalno funkcijo levega prekata. Pulmonalna stenoza (gradient > 30 mm Hg) je bila ugotovljena pri 2 bolnikih. Samo pri enem bolniku je bila ugotovljena zmerna insuficienca neoaortne zaklopke (1,0%). Zaključki. Z anatomsko korekcijo transpozicije velikih arterij v neonatalnem obdobju so bili doseženi zelo dobri zgodnji in srednjeročni rezultati. Z anatomsko korekcijo postane morfološko levi prekat sistemski prekat, kar je ključno za dolgoročno delovanje sistemskega prekata.
Deskriptorji		TRANSPOSITION OF GREAT VESSELS HEART SEPTAL DEFECTS, VENTRICULAR INFANT PREOPERATIVE CARE POSTOPERATIVE COMPLICATIONS SLOVENIA SLOVAKIA