ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Tertiary care center experience regarding the early approach to transposition of the great arteries
Senem Özgür, Özben Ceylan, Utku Arman Örün, Mehmet Emre Arı, Vehbi Doğan, Mahmut Keskin, Osman Yılmaz, Selmin Karademir
Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.8977
Background: This study aims to examine the effectiveness of balloon atrial septostomy in transposition of the great arteries patients and to evaluate possible factors influencing the procedure.

Methods: Between January 2005 and January 2012, a total of 111 patients (67 boys, 44 girls; mean age 18.2±20.3 days; range 1 to 105 days) younger than four months with the diagnosis of transposition of the great arteries who had either an interventional or diagnostic catheter procedure in our clinic were included in the study. The patients were divided into two main groups including those with (n=83) and without septostomy (n=28). The septostomy group was also divided into two subgroups including before and after septostomy.

Results: The mean preoperative angiographic aortic saturation was 50.6±16.3%, while the mean postoperative angiographic aortic saturation was 75.0±11.8%. During the procedure, the mean increased saturation was 24±15.2%, indicating statistical significance (p<0.05). The mean preoperative and postoperative left atrial pressure in the balloon atrial septostomy group was 13.3±5.3 (5.0-24.0) mmHg and 9.5±4.5 (3.0-20.0) mmHg, respectively. The mean gradient between the right and left atria before the procedure was 6.2±5 (0-19.0) mmHg and 0.9±1.3 (0-5.0) mmHg after the procedure. The difference was statistically significant (p<0.05). The factor of male sex increased the possibility of septostomy by 2.6-fold, the absence of atrial septal defect by 9.6-fold, and intact ventricular septum by 3.6-fold.

Conclusion: Balloon atrial septostomy is a relatively safe and effective procedure, although the ideal treatment is the arterial switch operation in transposition of the great arteries patients in the early stages.

Keywords : Cyanosis; heart defect; transposition of the great arteries
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