PMID- 14759418
OWN - NLM
STAT- MEDLINE
DCOM- 20040317
LR  - 20131121
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 77
IP  - 2
DP  - 2004 Feb
TI  - Late results of palliative atrial switch for transposition, ventricular septal 
      defect, and pulmonary vascular obstructive disease.
PG  - 464-8; discussion 468-9
AB  - BACKGROUND: Palliative atrial switch (PAS) procedures that reroute pulmonary and 
      systemic venous drainage and leave a ventricular septal defect (VSD) open have 
      been used in the treatment of deeply cyanotic patients who have severe pulmonary 
      vascular obstructive disease (PVOD). Palliative atrial switch is beneficial for 
      patients with transposition of the great arteries or other complex lesions with 
      VSD who show higher arterial oxygen saturation in the pulmonary artery than in 
      the aorta (transposition hemodynamics/unfavorable streaming). We reviewed the 
      early and late results of PAS (Mustard, n = 25; Senning, n = 3) in patients at 
      two institutions. METHODS: Between April 1965 and March 2000, PAS was performed 
      in 28 cyanotic patients (18 male, 10 female). Median age was 10 years (range, 1 
      to 27). Mean preoperative pulmonary arterial pressure was 68 mm Hg (range, 30 to 
      121 mm Hg). Mean systemic arterial oxygen saturation was 65% (range, 47% to 80%). 
      The majority of patients (95%) were in New York Heart Association (NYHA) 
      functional class III or IV preoperatively. RESULTS: Overall early mortality was 
      21%; for patients after 1972 (n = 23), the early mortality was 8.7%. Mean 
      follow-up was 8.3 years (maximum 20). Mean postoperative systemic arterial oxygen 
      saturation was increased significantly to 88% (p < 0.0001). Late survival for 
      early survivors at 5, 10, and 15 years respectively was 84% (59%, 97%), 64% (39%, 
      88%), and 54% (15%, 72%). The NYHA functional class was significantly improved; 
      94% of late survivors (n = 17) were in functional class I or II (p = 0.002). 
      CONCLUSIONS: The PAS operation significantly improves systemic arterial oxygen 
      saturation and quality of life in selected patients with transposition 
      hemodynamics, VSD, and severe PVOD.
FAU - Burkhart, Harold M
AU  - Burkhart HM
AD  - Division of Cardiovascular Surgery, Mayo Clinic and Mayo Foundation, Rochester, 
      Minnesota USA.
FAU - Dearani, Joseph A
AU  - Dearani JA
FAU - Williams, William G
AU  - Williams WG
FAU - Puga, Francisco J
AU  - Puga FJ
FAU - Mair, Douglas D
AU  - Mair DD
FAU - Ashburn, David A
AU  - Ashburn DA
FAU - Webb, Gary D
AU  - Webb GD
FAU - Danielson, Gordon K
AU  - Danielson GK
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Atria/*surgery
MH  - Heart Septal Defects, Ventricular/mortality/*surgery
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Oxygen/blood
MH  - *Palliative Care
MH  - Postoperative Complications/*etiology/mortality
MH  - Pulmonary Veno-Occlusive Disease/*congenital/mortality/*surgery
MH  - Reoperation
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Transposition of Great Vessels/mortality/*surgery
EDAT- 2004/02/05 05:00
MHDA- 2004/03/18 05:00
CRDT- 2004/02/05 05:00
PHST- 2004/02/05 05:00 [pubmed]
PHST- 2004/03/18 05:00 [medline]
PHST- 2004/02/05 05:00 [entrez]
AID - S0003497503013493 [pii]
AID - 10.1016/S0003-4975(03)01349-3 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2004 Feb;77(2):464-8; discussion 468-9. doi: 
      10.1016/S0003-4975(03)01349-3.