Objective: This study is designed to assess the preoperative management strategy for patients with transposition of the great arteries and intact ventricular septum(TGA-IVS).
Methods: Twenty eight patients with TGA-IVS were reviewed. We analyzed their clinical characteristics, method of diagnosis, preoperative management and outcome, mortality rate and the complication incidence before surgical operation.
Results: There were 19 boys and 9 girls in this group, had mean gestational age of 38+4 weeks and birth weight of 3.244kg. 7 cases (25%) were prenatal diagnosis, while the remaining 21 cases were postnatal diagnosis at the mean age of 45 hours. The karyotype was normal in those tested and no extracardiac anomalies. Cyanosis is the most common and critical characterization been noticed, diagnosis generally can be confirmed by echocardiography. All patients received prostaglandin E2 (PGE2) infusion once highly suspected or confirmed with TGA-IVS, 25 of this (89%) effectively maintained the patency of the ductus arteriosus preoperative and was stopped PGE2 after Balloon atrial septostomy (BAS). BAS was performed successfully in all cases at the mean age of 21 hours, as judged by oxygen saturation increased from (56±26)% before BAS to (82±19)% after BAS(P<0.05). Both preoperative mortality and serious morbidity were 3.5%, nine cases(32%) went home between BAS and surgery.
Conclusions: All cases in our group managed with PGE2 and BAS preoperative, which was safe and effective, may dramatically improve oxygenation, reduced preoperative mortality and morbidity, supported life until definitive surgery can be performed.