Mehmet Salih BİLAL, Arda ÖZYÜKSEL, Mustafa Kemal AVŞAR, Özgür YILDIRIM

Doğumsal büyük arterlerin düzeltilmiş transpozisyonu ve hazır olmayan sistemik ventrikül olan bir hastada acil double switch operasyonu

Doğumsal büyük arterlerin düzeltilmiş transpozisyonu nadir görülen bir kalp anomalisidir. Doğumsal büyük arterlerin düzeltilmiş transpozisyonu tanısı konmuş dokuz aylık bir erkek bebek üç ay önce sol ventrikülün hazırlanması amacıyla pulmoner arter bantlama öyküsü ile kliniğimize başvurdu. Başvuru sırasında hasta bronkopnömoni, siyanoz, solunum sıkıntısı ve ciddi kapak yetmezliği ile ilişkili biventriküler kalp yetmezliği tablosunda idi. Atriyal ve arteriyal switch işlemleri ile birlikte acil double switch operasyonu yapıldı. Ameliyat sonrasında sekiz günlük mekanik dolaşım desteği zaruri görüldü. Hasta ameliyattan üç yıl sonra halen sorunsuz izlenmektedir.

Urgent double switch operation in a patient with congenitally corrected transposition of great arteries and an untrained systemic ventricle

Congenitally corrected transposition of the great arteries is arare cardiac abnormality. A nine-month-old male infant withthe diagnosis of congenitally corrected transposition of the greatarteries was admitted to our clinic with a history of pulmonaryartery banding to train the left ventricle three months ago. Onadmission, he presented with bronchopneumonia, cyanosis,dyspnea, and severe biventricular heart failure associated withsignificant valvular regurgitation. An urgent double switchoperation was performed with atrial and arterial switchprocedures. Eight days of mechanical circulatory support wasdeemed mandatory following surgery. The patient is still underfollow-up uneventfully three years after the operation.

PDF

___

1. Brawn WJ, Barron DJ, Jones TJ, Quinn DW. The fate of the retrained left ventricle after double switch procedure for congenitally corrected transposition of the great arteries. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2008:69-73.
2. Sebastian VA, Cooley A, Ramaciotti C, Guleserian KJ, Forbess JM. Neonatal double switch for congenitally corrected transposition with Ebstein anomaly and bilateral superior venae cavae. J Thorac Cardiovasc Surg 2014;148:e241-2.
3. Bilal MS, Avşar MK, Yıldırım Ö, Özyüksel A, Zeybek C, Küçükosmanoğlu O, et al. Double Switch Procedure and Surgical Alternatives for the Treatment of Congenitally Corrected Transposition of the Great Arteries. J Card Surg 2016;31:231-6.
4. Devaney EJ, Charpie JR, Ohye RG, Bove EL. Combined arterial switch and Senning operation for congenitally corrected transposition of the great arteries: patient selection and intermediate results. J Thorac Cardiovasc Surg 2003;125:500-7.
5. Bove EL, Ohye RG, Devaney EJ, Kurosawa H, Shin'oka T, Ikeda A, et al. Anatomic correction of congenitally corrected transposition and its close cousins. Cardiol Young 2006;16 Suppl 3:85-90.
6. Ibrahimiye AN, Mainwaring RD, Patrick WL, Downey L, Yarlagadda V, Hanley FL. Left ventricular retraining and double switch in patients with congenitally corrected transposition of the great arteries. World J Pediatr Congenit Heart Surg 2017;8:203-9.
7. Boutin C, Wernovsky G, Sanders SP, Jonas RA, Castaneda AR, Colan SD. Rapid two-stage arterial switch operation. Evaluation of left ventricular systolic mechanics late after an acute pressure overload stimulus in infancy. Circulation 1994;90:1294-303.
8. Myers PO, del Nido PJ, Geva T, Bautista-Hernandez V, Chen P, Mayer JE Jr, et al. Impact of age and duration of banding on left ventricular preparation before anatomic repair for congenitally corrected transposition of the great arteries. Ann Thorac Surg 2013;96:603-10.
9. Ishibashi N, Aoki M, Fujiwara T. Double switch operation in a young infant. Cardiol Young 2004;14:661-3.