Arterial switch operation in children over 6 months

Objective:To investigate effects of arterial switch operation (ASO)in children over 6 months. Method:From June 2009to July 2012,children scheduled for ASO were divided into A group(6months,n= 24)and B group (≥6 months,n=18),and ASO performed after preoperative treatments and examinations. Effects of ASO,3months follow up echocardiography and complications were observed.The records about ASO from two groups were compared in terms of operating time,cardiopulmonary bypass time,cardiac arrest time and automatic cardioversion in operation.Circulation function records from two groups such as mean pulmonary artery pressure(MPAP),mean arterial pressure(MAP)and central venous pressure(CVP)right after blood ultrafiltra- tion,inotropic scores at ICU were made contrasts.The change of MPAP before and after operation in two groups were observed.The records in ICU were compared included ICU time,ventilation time,frequency of re-intubation and pulmonary infection.Result:Two infants died in the first day after operation in group A,the others were clini- cally cured,and 12cases had contented follow-up echocardiography examinations 3months later and had no com- plications.Sudden death accurred to 1case in group B in hospital,other children were clinically cured,7cases had satisfactory echocardiography and complications follow-up 3 months later,and 1case suffered sudden death at home.There was no statistical difference between two groups as to operating time,cardiopulmonary bypass time, cardiac arrest time and automatic cardioversion in operation.MAP in two groups right after blood ultrafiltration in operation had no statistical difference.MPAP in two groups descended obviously after operation (P0.05). Compared with group A,children in group B had higher MPAP,CVP right separation from modified ultrafiltra- tion,higher inotropic scores at ICU,longer ICU time and ventilation time,higher frequency of re-intubation and pulmonary infection postoperation(all P0.05).Conclusion:ASO in children over 6months appear more compli- cations,slower recovery and have an unstable pathogenetic condition,the elder children may be suffered from sud- den death.