Abstract:

 Objective     To review and sum up the clinical experience of complex congenital heart disease in children (including complete transposition of great arteries and TaussigBing heart malformation) by arterial switch operation in a single surgical group. Methods      Arterial switch operation were performed on 56 children with complex congenital heart disease, including 37 males and 19 females, whose age ranged from 6 days to 9 years old and the weight from 2.55 to 18 kg. Among them, there were 40 complete transposition of great arteries,  16 Taussig-Bing heart malformations, 15 TGA/IVS , 25 TGA/VSD, associated with 10 atrial septal defect, 32 patent ductus arteriosus  and 8 mild pulmonary valve stenosis. All cases were treated with arterial switch operation under CPB. Cold blood cardioplegia or HTK solution was used for myocardial preservation, while modified ultrafiltration was applied. Results      The CPB time and aortic clamping time were 150~259min, and 78~163min correspondingly. There were six deaths in the early time after the operation, including three cases of hemorrhage (one case due to releasing of suture of PDA ), one case died of pulmonary hypertension crisis in the twelfth hour after arterial switch operation, one case died of renal failure in the fifth day, one case died of low cardiac output syndrome in the twenty-second day, postoperative intensive care unit stay was 5~22 days, the hospital stay 14~48 days. During three months to seven years′ follow-up, one case with single coronary artery died of pneumonia and heart failure in the sixth month after discharge. Cyanosis of the remaining fortynine cases disappeared, activity increased greatly, growth and development were good and quality of life improved significantly, heart function were class I(NYHA classification). Pulmonary pressure difference of eight cases with pulmonary stenosis decreased after surgery. Conclusion     The arterial switch operation is an ideal surgical procedure for congenital heart disease in children (including complete transposition of great arteries and Taussig-Bing heart malformation) , satisfying results can be got.

Key words: Heart defects, congenital; Arterial switch operation; Complete transposition of great  artery; Taussig-Bing heart malformation