Long-term results of anatomical repair of transposition of the great arteries.

The long-term complications after anatomical repair of transposition of the great arteries (TGA) were analysed in a prospective study of 30 successive patients, from August 1996 to October 1999, who were presumed asymptomatic and investigated 10 years after surgery. All underwent clinical examination, ECG, stress Thallium 201 myocardial sci ntigraphy, Doppler echocardiography, Holter ECG, pulmonary perfusion scinti graphy, right and left cardiac catheterisation with selective coronary angi ography. Five patients had coronary lesions (4 thromboses and 1 coronary-pu lmonary artery fistula). The other abnormalities observed were mild bilater al stenosis of the two pulmonary arteries (1 case), grade 1 aortic regurgit ation (6 cases), including 1 case of aortic root dilatation. Type B to E co ronary circulations (Yacoub classification) were not significantly correlat ed with coronary artery disease in this series (p = 0.06). For the diagnosi s of these lesions, myocardial scintigraphy and Doppler echocardiographic d etection of wall motion abnormalities had a sensitivity of 50% and respecti ve specificities of 88% and 35%. Long-term results after anatomical repair of TGA are satisfactory. However, the high incidence of coronary lesions makes regular follow-up and systema tic coronary angiography necessary in all children.