Minimally invasive cardiac surgery for transposition of the great arteries in neonates

We evaluated our results of arterial switch operation (Jatene) for complete transposition of the great arteries between May 2003 and October 2005 particularly concerning various operation-related durations. Twenty neonates were studied. The mean age and body weight were 11.6 +/- 2.7 (range 5 to approximately 15) days and 3.0 +/- 0.4 kg, respectively. Duration of anesthesia, operation, extracorporeal circulation (ECC), and aortic cross-clamp were 199.4 +/- 30.1, 162.7 +/- 29.9, 91.6 +/- 8.8 and 59.8 +/- 8.1 minutes, respectively. Time differences between anesthesia and operation, operation and ECC, ECC and aortic cross-clamp were calculated, and their correlations with the duration of anesthesia were investigated. The items, whose coefficient of correlation with anesthetic time was greater than 0.6 were operation time, ECC time, aortic cross-clamp time, operation time minus ECC time, and operation time after ECC come-off. Furthermore, the operation time after ECC come-off was strongly correlated with plasma lactate concentrations and intraoperative bleeding. In conclusion, the time required for hemostasis and closure of the chest should be as short as possible. Therefore secure anastomoses with least hemorrhage possible is important.