ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
NEO-PULMONARY ARTERY STENOSIS AFTER ARTERIAL SWITCH OPERATION
Yusuf KALKO, Faruk HÖKENEK, Kenan SEVER, Tolga DEMİR, Emin TİRELİ, Enver DAYIOĞLU, * Aygün DİNDAR, Ertan ONURSAL
İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Göğüs Kalp Damar Cerrahisi Anabilim Dalı, İSTANBUL
*İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Pediatrik Kardiyoloji Bilim Dalı, İSTANBUL
The surgical approach of the transposition of the great arteries is the anatomical correction by arterial switch operation. The most common cause of reoperation after this procedure is neo-pulmonary stenosis. The factors influencing the neopulmonary artery stenosis rates seem coronary arterial pattern, operation time, relationship of the great vessels and surgical technique. The reported rate of neopulmonary stenosis ranged between 5% and 20% in literature.

In our department 40 patients ith D-TGA underwent arterial switch operation between 1997 and 2000. In 30 patients we referred echocardiography evulation in early and late postoperative periods to search neo-pulmonary stenosis. In 1 patient we determined modarate degree transpulmonary gradient (20 mmHg ). The echocardiographic evulation of the remaning patients revealed unsignificant gradient (< 15 mmHg). 6 months after the operations we performed second echocardiographic evaluation and determined 2 severe (> 30 mmHg), two modarate (20 mmHg) pulmonary stenosis. Other patients had insignificant pulmonary gradients. This complication is more common in our first 15 cases. We didn’t measure a sigwasnificant gradient in the last 15 cases. The patient with severe gradient was reoperated and we have been following him routinely. The other patient was died before the planned reoperation. We are believed that the neo-pulmonary stenosis after arterial switch operation is related to surgical technique and experience.

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