INTRODUCTION:
Transposition of the great arteries (TGA) is a common cyanotic
congenital heart disease either in isolation or as a part of more
complex congenital cardiac anomalies. Since its inception in 1975 by
Jatene, the arterial switch operation (ASO) has become the standard
method for surgical repair of the TGA1,2.
The goal of surgical repair is to have an anatomical correction. Part of
the surgical treatment is performing the Lecompte procedure where the
pulmonary arteries are relocated anteriorly4.
Furthermore, the neo-pulmonary artery is reconstructed, most often using
a pericardial patch. Although the current operative mortality is low and
the mid and late outcomes are satisfactory, there are still some
complications, one of which is the residual pressure gradient across the
pulmonary valve and reconstructed pulmonary
arteries3-6.
The pressure gradient across the neo-pulmonary artery (especially in the
supra-valvular area) is the most crucial determinant for reintervention,
though modifications of arterial switch operation have reduced the
occurrence of pulmonary stenosis4,5,7.
The reported incidence of reoperation related to pulmonary stenosis
after the arterial switch operation ranges from
5-30%5,8-10. Because the pulmonary artery pressure
gradient can vary with the somatic growth, we sought to examine the
behavior of the pulmonary artery pressure gradient over time and to
determine the contributing factors and its relationship with the need
for reintervention.