Subjects
Between January 2000 and June 2017, 11 patients (seven boys and four
girls) underwent complete one-stage repair of the transposition complex
with IAA through midline sternotomy at Beijing Fuwai Hospital. The
median age at the time of surgery was
five
months (range: 10 days–71 months), and only one patient was less than
one month old. The median body weight was 6.2 kg (range: 2.2–15.0 kg).
The study was conducted in accordance with the Declaration of Helsinki
(as revised in 2013) and was approved by the Ethics Committee of Beijing
Fuwai Hospital. The requirement of individual consent for this
retrospective analysis was waived.
There were two patients with TGA and ventricular septal defect (VSD) and
seven patients with Taussig-Bing anomaly (TBA). One patient had double
outlet right ventricle (DORV) and non-committed VSD, in which the VSD
was below the septal leaflet, but the overriding tricuspid valve was
absent. One patient with TGA had both perimembranous and muscular VSDs.
Right ventricular outflow tract obstruction (RVOTO) was present in four
patients and moderate mitral valve regurgitation in two patients. All
patients except one had IAA type A, and the other had type B IAA. The
relationships between the great arteries were
anteroposterior
in eight patients and
side-by-side
in the other three patients. The pulmonary-aorta ratio was observed to
be more than 1.5:1 in all the patients, while the most discrepant one
was 4:1. The coronary anatomies were normal (1L, Cx; 2R) in nine
patients, and a single coronary artery was present in two patients.
Intramural coronary arteries were not observed. Prostaglandin
E1 was administrated to the only newborn in this group
preoperatively. No balloon atrial septostomy, mechanical ventilation, or
inotropic support was required before definitive repair. Clinical data
are presented in Table 1.