Early Mortality
There were three early deaths (27.3%) among the 11 patients. The first
patient was patient 2, a 4-month-old female infant weighing 3.5 kg with
TGA, type A IAA. The relationship between the great arteries was
anteroposterior, with a remarkable discrepancy of 4:1. The patient had
both perimembranous and muscular VSDs and normal coronary artery anatomy
(1L, Cx; 2R), and underwent an uneventful surgery. However, an immediate
postoperative echocardiogram demonstrated a low left ventricular
ejection fraction of approximately 25%, without explicit
segmental wall motion abnormality. Severe pneumonia followed, and a
high-frequency oscillatory ventilator was used. The patient died of
sepsis on postoperative day (POD) 34.
The second was patient 3, a 10-day-old and 2.1 kg premature newborn girl
with TBA, type A IAA, side by side relationship of the great vessels
with significant mismatch 3:1, and a single coronary artery ostium at
sinus 1. The patient’s surgical procedure was uneventful. Moderate
aortic valve regurgitation was detected by echocardiography on POD three
but did not evolve thereafter. The patient’s chest was left open after
surgery and was not successfully closed until POD 13 because of
refractory
oliguria
and severe edema. The patient died of severe capillary leakage on POD
17.
The third patient was patient 8, a 2-month-old and 6.1 kg boy with TBA,
type A IAA, anteroposterior great vessels, and typical coronary artery
anatomy. The patient exhibited
anuria
one day after surgery and subsequently immediate renal failure. Soon
after, multiple organ dysfunction developed. After conferring with his
parents, therapy was stopped 26 days after the surgery; eventually, the
infant died.