211305 Investigation of the risk factors associated with early mortality of the rapid two-stage arterial switch operation

/Xu Zhiwei(徐志伟，Dept Thorac Cardiovascul Surg，Shanghai Jiaotong Univ Shanghai Children’s Med Center，Shanghai 200127)…∥Chin J Thorac Cardiovasc Surg.-2011，27(2).-87 ～89

ObjectiveTo investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation，which has a significantly higher overall mortality than that of ASO procedure for D-TGA with an intact ventricular septum.MethodsThe data we reviewed involving patients who underwent rapid two-stage switch operations from September，2002 to September，2007 in our center，13 patients were male and 8 were female，their age at operation ranged from 29 to 250 days afer birth，and the body weight was 3.5 to 7 kg.Chi-squared test and multivariant logistic regression methods were used for the analysis of demographic data，pre-diagnosis information，operation data，interval data combined with the operation time，left ventricle training condition，and the early postoperative outcomes.ResultsThe operative mortality was high at initial stage，and then decreased gradually.The logistic multivariant regression analysis indicated that the mortality of left ventricular training operation was associated with the diameters of BT shunt(P=0.003);the mortality of two-stage switch was associated with feminie(P=0.006)and pre-operative p.LV/RV(P ＜ 0.001).ConclusionPatients with transposition of the great arteries and intact ventricular septum who missed the optimal time for switch operation should receive rapid two-stage switch operations，which provide an opportunity for the correction of the deformity.The key factor associated with the success for operation was good in heart function after left ventricular training.11 refs，1 fig，2 tabs.