Subjects
Between January 2000 and June 2017, 11 patients (seven boys and four girls) underwent complete one-stage repair of the transposition complex with IAA through midline sternotomy at Beijing Fuwai Hospital. The median age at the time of surgery was five months (range: 10 days–71 months), and only one patient was less than one month old. The median body weight was 6.2 kg (range: 2.2–15.0 kg). The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and was approved by the Ethics Committee of Beijing Fuwai Hospital. The requirement of individual consent for this retrospective analysis was waived.
There were two patients with TGA and ventricular septal defect (VSD) and seven patients with Taussig-Bing anomaly (TBA). One patient had double outlet right ventricle (DORV) and non-committed VSD, in which the VSD was below the septal leaflet, but the overriding tricuspid valve was absent. One patient with TGA had both perimembranous and muscular VSDs. Right ventricular outflow tract obstruction (RVOTO) was present in four patients and moderate mitral valve regurgitation in two patients. All patients except one had IAA type A, and the other had type B IAA. The relationships between the great arteries were anteroposterior in eight patients and side-by-side in the other three patients. The pulmonary-aorta ratio was observed to be more than 1.5:1 in all the patients, while the most discrepant one was 4:1. The coronary anatomies were normal (1L, Cx; 2R) in nine patients, and a single coronary artery was present in two patients. Intramural coronary arteries were not observed. Prostaglandin E1 was administrated to the only newborn in this group preoperatively. No balloon atrial septostomy, mechanical ventilation, or inotropic support was required before definitive repair. Clinical data are presented in Table 1.