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Eur J Cardiothorac Surg 2007;31:135-137. doi:10.1016/j.ejcts.2006.09.032
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Case reports

One-stage neonatal corrective repair for d-transposition of the great arteries and complete atrio-ventricular canal

Victor Bautista-Hernandeza, Gerald R. Marxb, Pedro J. del Nidoa,*

a Department of Cardiac Surgery, Children's Hospital Boston, Harvard Medical School, United States
b Department of Cardiology, Children's Hospital Boston, Harvard Medical School, United States

Received 15 February 2006; received in revised form 27 September 2006; accepted 28 September 2006.

* Corresponding author. Address: Department of Cardiac Surgery, Children's Hospital Boston, 300 Longwood Avenue, Bader 273, Boston, MA 02115, United States. Tel.: +1 617 355 8290; fax: +1 617 730 0214. (Email: pedro.delnido{at}tch.harvard.edu).

Association of d-transposition of the great arteries and complete atrio-ventricular canal constitutes an uncommon and complex cardiac anomaly usually associated with poor prognosis. We report our experience on one-stage neonatal repair for d-transposition of the great arteries and complete atrio-ventricular canal. Between August 1997 and 2005, four patients (two males and two females) underwent anatomical correction for d-transposition of the great arteries and complete atrio-ventricular canal using an arterial switch procedure and two-patch repair. Mean age and weight at operation were 20 days (range from 3 to 28 days) and 3.2 kg (range from 2.7 to 3.5 kg), respectively. None of the patients received preoperative palliative procedure. Associated lesions were left outflow tract obstruction in three patients and multiple muscular ventricular septal defects in two patients. All four patients survived the operation. There was one in-hospitality death due to fungal sepsis. One patient required late re-operation for left ventricular outflow tract obstruction and left atrio-ventricular valve regurgitation. For a mean follow-up of 67 months (range from 51 to 90 months) all patients are asymptomatic and with no residual defects. Corrective repair of d-transposition of the great arteries and complete atrio-ventricular canal can be successfully achieved in this very challenging population during the neonatal period.

Key Words: Transposition of the great arteries • Atrio-ventricular canal defect • Arterial switch






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.