[Long term outcome of arterial switch surgery for transposition of the great arteries: evaluation of the reconstruction of the pulmonary artery].

The research article discusses the long-term effects of a surgical procedure known as the arterial switch, specifically focusing on the reconstruction of the pulmonary artery, for the treatment of a congenital heart condition called the transposition of the great arteries. The study compares the outcomes of three different surgical techniques used over a period of 15 years.

Study Participants and Methods

• The study was conducted over a span from September 1991 till December 2006, involving a total of 65 patients who underwent Lecompte procedure – a surgical intervention to correct the transposition of the great arteries.
• The researchers categorized the participants into three distinct groups based on the method used to reconstruct the pulmonary artery during surgery. The three methods are the single pantaloon patch with equine pericardium (XP group, 11 patients), direct reconstruction (P group, 47 patients), and the single pantaloon patch with fresh autopericardium (AP group, 7 patients).
• Post-surgery, all the patients were monitored for pulmonary stenosis (narrowing of the pulmonary artery), by assessing the pulmonary arterial maximum flow velocity using ultrasound cardiography (UCG).

Study Findings

• The median follow-up years varied for each group: 13 years for XP group, 7.5 years for the P group, and 1.3 years for the AP group.
• Across all groups, both early and late mortality rate post-surgery was calculated to be 1.5% (1 out of 65 patients).
• Need for percutaneous trans-pulmonary angioplasty (a procedure to widen the pulmonary artery) varied across the groups, with it being necessary for 1, 13, and 3 patients in XP, P, and AP groups respectively.
• Similarly, the need for reoperation due to pulmonary stenosis was noted to be 1, 1, and 0 in the XP, P, and AP groups respectively.
• With regards to pulmonary stenosis, as assessed by UCG, prevalence rates were 40% in the XP group, 30% in the P group, and 43% in the AP group.

Conclusions

• No significant difference was found among the three surgical methods in terms of their ability to prevent pulmonary stenosis up to 10 years after the arterial switch surgery.
• However, it was suggested that the direct reconstruction of the pulmonary artery may provide better outcomes, particularly for durations exceeding 10 years post-surgery.