Objective To investigate the application value of echocardiography in two-stage double switch(DS)operation in children with corrected transposition of the great arteries(CTGA).Methods The echocardiography was used to analyze the preoperative diagnosis of pulmonary ring ligation(PAB)operation in 17 CTGA children with two-stage DS operation in the department of surgery.Left ventricular morphology and hemodynamics before and after PAB were compared.Left ventricular hemodynamics before and after DS operation were observed by echocardiography.Results Among 17 children with CTGA,15 cases(88.24%)were diagnosed correctly by echocardiography before PAB operation,2 cases(11.76%)were misdiagnosed as atrioventricular discordant connection double outlet of right ventricle.After PAB operation,the inner diameter of pulmonary artery and the width of tricuspid valve regurgitant bundle decreased,while the left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular posterior wall end-diastolic thickness,ventricular septal diastolic thickness,left ventricular mass and pulmonary artery flow velocity increased significantly,and the degree of regurgitant decreased,with statistical significance compared with those before PAB operation(all P<0.05).Left ventricular myocardial work index(MPI)increased significantly,right ventricular MPI and left ventricular ejection fraction decreased significantly after DS operation,with statistical significance compared with those of DS operation(all P<0.05).Among the 6 children with cardiac insufficiency(3 deaths,3 follow-up),the ventricular septum was intact in 3 cases,and the ventricular septal defect(diameter of 0.13 cm,0.15 cm,0.18 cm,respectively)in 3 cases.Among 11 children with normal cardiac function,the average diameter of ventricular septal defect was(0.37±0.18)cm.Conclusion CTGA could be diagnosed accurately by echocardiography,and the left ventricular mass of children with CTGA after PAB operation is significantly improved,which is feasible DS operation.Cardiac insufficiency and aortic regurgitation are common complications after DS operation.
EchocardiographyCorrected transposition of the great arteriesDouble switch operation,two-stagePulmonary artery banding
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