Læknablaðið - 15.07.1998, Page 9

LÆKNABLAÐIÐ 1998; 84
533
Slagæðavíxlun við hjarta
á íslandi 1971-1996
Herbert Eiríksson1), Hróðmar Helgason"
Eiríksson H, Helgason H
Transposition of the great arteries in Iceland over
a 26 year period from 1971 to 1996
Læknablaðið 1998; 84: 533-40
Objective: We reviewed our experience regarding
D- and L-transposition of the great arteries (D- and
L-TGA) in Iceland over a 26 year period, from 1971
to 1996. We looked at incidence, diagnosis, treatment
and outcome and any changes in these parameters
during the study period were noted.
Material and methods: Data were obtained from
hospital records which contained echocardiographic,
cardiac catheterization- and autopsy reports.
Results: There were 31 children diagnosed as having
transposition of the great arteries during the study
period, 29 had D-TGA. Follow-up period was from
11 months to 21 years (median 13 years). The inci-
dence was 1:3681 births and male to female ratio
2.4:1.
Cardiac catheterization was used as a diagnostic tool
in 11 cases, but as of 1984 all diagnoses were made
by echocardiography. Of the patients with D-TGA,
21 (72%) had no additional cardiac defects, however
when these were present, a ventricular septal defect
was most common. Twenty-six patients (84%)
underwent a balloon atrial septostomy and it was
successful in 24 (92%).
Twenty-three of 31 patients (74%) have had cardiac
surgery, all fully corrective. Of the 23 surgeries, 21
were done in London, England. Fifteen children had
atrial switch repair, a Mustard operation was done
twice and Senning in 13 patients. In five cases an
arterial switch operation was performed and three
Frá ''Barnaspítala Hringsins. Fyrirspurnir, bréfaskipti: Her-
bert Eiríksson læknir, Barnaspítala Hringsins, Landspítal-
inn, Reykjavík. Sími: 560-1000; bréfsími: 560-1055.
Lykilorð: slagæðavíxlun við hjarta, hjartagallar, með-
fæddir hjartasjúkdómar.
patients had other surgeries. Half of the patients had
a difficult post operative course, however there was
only one death within the first month following
surgery.
Of the 31 children born with TGA from 1971 to
1996, eight (26%) have died and two are lost to
follow-up. All the patients that died were born during
the first half of the study period. Of these eight
children, four died within the first four days of life.
Corrective cardiac surgery had been done on two
patients before death.
There are 21 patients alive which updated informa-
tion is available on. All are in good condition leading
full active lives. Five patients are needing prescrip-
tion medications, thereof two antiarrhythmics. Of the
most recent echocardiograms, 16 are without hemo-
dynamically significant sequela. In five cases how-
ever, echocardiography shows significant abnorma-
lities, probably warranting intervention within the
next few years.
Conclusions: The diagnosis, treatment and outcome
of patients with transposition of the great arteries has
improved dramatically over the years. Close follow-
up of these patients with regards to sequela of car-
diac surgery is mandatory, especially since the majo-
rity of this patient population has had atrial switch
repair.
Key words: D and L-transposition of the great arteries,
congenitat heart defects, congenital heart disease.
Ágrip
Tilgangur: Rannsóknin varðar slagæðavíxl-
un við hjarta (D- and L-transposition of the
great arteries) á íslandi á 26 ára tímabili, 1971-
1996. Skoðað var nýgengi sjúkdómsins, grein-
ing, meðferð og horfur og hvernig þessir þættir
hafa breyst á rannsóknartímanum.
Efniviður og aðferðir: Gagna var aflað úr
sjúkraskrám sem innihéldu hjartaómskoðunar-,
hjartaþræðingar- og krufningaskýrslur.