Clinical Analysis Of Switch Operation For Complete Transposition Of Great Arteries

Objective:To evaluate the treatment efficacy of complete transposition of great arteries by Switch surgery.Methods: A retrospective analysis was made of 10 children with TGA treated by switch in the First Affiliated Hospital of Guangxi Medical University from 2014 to 2018 period.9 cases were combined with VSD and 1 cases were without VSD.The minimum age is 1 days,the maximum age is 375 days,the average age is 77.60 ± 118.29 days,the average weight is 4.20 ± 0.77 kg.To compare preoperative with postoperative 1 week,postoperative 1month,postoperative 3 month children's pulmonary artery pressure,left ventricular ejection fraction and left ventricular mass index and cyanosis symptoms,the sample size was analyzed by paired t test.Results:The operative effect of 10 cases in this group was satisfactory.10 patients before surgery were obvious cyanosis,1 weeks after surgery in children with cyanotic conditions significantly improved.Preoperative pulmonary artery pressure mean value was 37.40 ± 10.30 mmhg,1 weeks afteroperation was 31.60 ± 9.03 mmhg,1 months after the operation was 20.30±4.11 mmhg,3 months after the operation was 16.22 ± 1.48 mmhg.To compare preoperative with postoperative 1 week,postoperative 1 month,postoperative 3month children's pulmonary artery pressure,the P value was less than 0.05,and the difference was statistically significant.The mean value of preoperative left ventricular ejection fraction was 62.9 ± 1.85%,1 weeks after operation was 60.6± 8.67%,1 months after operation was 71.67 ± 2.24%,and 1 months after operation was 71.78 ± 2.28%.The left ventricular ejection fraction before operation was compared with the 1 weeks after operation.The P value was more than 0.05,and the difference was not statistically significant.To compare preoperative with postoperative 1 month,postoperative 3 month children's left ventricular ejection fraction,the P value was less than 0.05,and the difference was statistically significant.Preoperative left ventricular mass index mean value was 57.55 ± 13.47 g/m2,1 weeks after operation was 72.92 ± 17.22 g/m2,1months after the operation was 115.31±7.02 g/m2,3 months after the operation was 125.03 ± 4.23 g/m2.To compare preoperative with postoperative 1week,postoperative 1 month,postoperative 3 month children's left ventricular mass index,the P value was less than 0.05,and the difference was statistically significant.Conclusion:The switch operation corrected the hemodynamics from the anatomy.After operation,the body circulation and pulmonary circulation formed a cross cycle,increased blood oxygen content,improved the symptomsof cyanosis and made the right heart blood into the pulmonary artery with relatively low pressure.The pulmonary artery pressure gradually decreased,and basically decreased to normal range after 3 months.The left heart connects the aorta with high resistance,makes the left ventricular myocardium develop,the left ventricular mass index increases,and then increases the myocardial contractility,thus improving the left heart function of the patients.