Follow-up of patients who underwent arterial switch repair for transposition of the great arteries
J. C. Mendoza, S. A. Wilkerson and A. H. Reese
Department of Pediatrics, University of Louisville, KY 40292.
Thirty infants underwent arterial switch for transposition of the great
arteries within the first week of life (mean age, 2.8 days). An additional
three patients underwent repair at 5 1/2, 8, and 9 1/2 months of age. Six
(18.2%) of 33 patients died. All the survivors were not receiving cardiac
medications or diuretics at the time of the last follow-up visit.
Examination of 24 of 27 survivors at 1 to 5 years of age revealed normal
growth in 75% of the patients. Two patients had height, weight, and head
circumference below the fifth percentile for age. Four patients had height
and weight appropriate for age but head circumference below the fifth
percentile. Neurodevelopmental testing yielded normal findings in 18
patients. Three patients were considered suspect and an additional three
were abnormal neurodevelopmentally. Head circumference less than the fifth
percentile, abnormalities on computed tomographic scans of the brain, and
emergency balloon atrial septostomy or emergency switch operation were more
likely to occur in patients who had low neurodevelopmental scores. We
conclude that the majority of patients who undergo arterial switch repair
demonstrate normal growth and development and no impairment of
cardiovascular function. However, significant morbidity in the form of
neurodevelopmental problems may occur.
