Heart 1998;79:211-212 ( March )
Editorial
Stenting of systemic venous pathways after atrial repair for complete transposition
| The first 150 words of the full text of this article appear below. |
Atrial repair (Mustard and Senning operations) for complete
transposition has been replaced in most paediatric cardiology centres
by the arterial switch operation, which is performed in the first few
days or weeks of life.1 Arterial switch avoids many of the
major complications of atrial repair: sinus node damage results in loss
of sinus rhythm, atrial arrhythmias, bradycardias, and the need for
antiarrhythmic medication and pacemaker implantation.2,3 Systemic (morphological right) ventricular dysfunction and failure, when it occurs, requires either heart transplantation or takedown of
the original repair and conversion to an arterial switch
operation.4,5 Late sudden death is not always related to
these complications and is unpredictable.2,3,6 Systemic
and pulmonary venous pathway obstruction can cause significant
morbidity and mortality as does repeat surgery.7 Balloon
dilatation and, recently, stent implantation have been used to avoid
repeat surgery for pathway obstruction.8-11 A trend
towards a "double switch" (Senning or Mustard operation
and arterial
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This article has been cited by other articles:
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Gibbs, J. L
(2000). Congenital heart disease: Interventional catheterisation. Opening up II: venous return, the atrial septum, the arterial duct, aortopulmonary shunts, and aortopulmonary collaterals. Heart
83: 237-240
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