Optimization of treatment of patients with transposition of great arteries

Transposition of great arteries (TGA) is the most widespread blue heart disease. The incidence of TGA varies within the range of 6.0 % to 15.7 % patients with CHD. Recently there has been a decrease in lethality at the majority of all large centers involved in treatment of patients with TGA. In recent two years, starting since 2008, we have been also observing a drop of hospital lethality after arterial switch operations. Over a period of 2008 - 2009 this technique has been applied for 51 infants with TGA at NRICP's Pediatric and Congenital Heart Surgery Center. Early fetal screening for critical CHD within the period of 18-22 weeks followed by expert examination at a specialized center allows for optimizing the period of successful treatment of CHD patients. The development of regional and municipal perinatal centers at the maternity houses and cooperation with them makes it possible to improve the process of providing medical care to newborns with all kinds of critical CHD. Regular advice of medical staff relating to management of newborns with critical CHD and the time for delivering infants to specialized cardiac surgery centers contributes to the creation of a well-organized and controllable treatment process. Versatility of surgical equipment and anesthetic management of newborns with TGA has enabled to improve the results of surgical treatment. In 2007 mean lethality after arterial switch operations on the territory of Russian Federation accounted for 27.3 % (Lubomudrov, 2009). At our center total lethality has amounted to 9.8 % over a period of 2008 - 2009 and there has been none for the last 6 months of 2009.