WU Xiao-yun, et al. Preoperative management strategy for patients with transposition of the great arteries and intact ventricular septum. [J]. Journal of Chongqing Medical University 34(3):331-334(2009)
WU Xiao-yun, et al. Preoperative management strategy for patients with transposition of the great arteries and intact ventricular septum. [J]. Journal of Chongqing Medical University 34(3):331-334(2009)DOI:
Preoperative management strategy for patients with transposition of the great arteries and intact ventricular septum
Objective:To assess the preoperative management strategy for patients with transposition of the great arteries and intact ventricular septum(TGA-IVS). Methods:Twenty eight patients with TGA-IVS were reviewed. We analyzed their clinical characteristics
method of diagnosis
preoperative management and outcome
mortality rate and the complication incidence before surgery. Results:There were 19 boys and 9 girls in this group
with the mean gestational age of 38+4 weeks and birth weight of 3.244 kg. 7 cases (25%)were prenatal diagnosis
while the remaining 21 cases were postnatal diagnosis at the mean age of 45 hours. The karyotype was normal in those tested and no extracardiac anomalies were found. Cyanosis was the most common and critical characterization been noticed. Diagnosis generally could be confirmed by echocardiography. All patients received prostaglandin E2 (PGE2)infusion once highly suspected of or confirmed with TGA-IVS
25 of whom(89%)effectively maintained the patency of the ductus arteriosus preoperatively and was stopped PGE2 after Balloon atrial septostomy(BAS). BAS was performed successfully in all cases at the mean age of 21 hours
as judged by oxygen saturation increased from(56±26)% before BAS to(82±19)% after BAS(P<0.05). Both preoperative mortality and serious morbidity were 3.5%. Nine patients(32%)went home during BAS and surgery. Conclusions:All cases in our group managed with PGE2 and BAS preoperatively
which proves to be safe and effective
may dramatically improve in oxygenation
reduce preoperative mortality and morbidity
support life until definitive surgery can be performed.