To evaluate the differences in patch-materials used to reconstruct the pulmonary artery in
arterial switch operation for transposition of the great arteries, we compared mid-term results in 50 consecutive survivors who underwent
arterial switch operation. In 35 patients (XP-group), the pulmonary artery was reconstructed using a
glutaraldehyde-treated heterologous pericardial patch, while in 15 patients (AP-group) it was reconstructed using a fresh autologous pericardial patch. A W-shaped patch was used in 14 patients of the XP-group. In 21 patients of the XP-group and all those of the AP-group, a square patch was used. The mean length of follow-up has been 94.1 +/- 38.1 months after surgery in XP-group, and 16.7 +/- 11.8 months in AP-group, respectively. Four patients in XP-group required balloon angioplasty for
pulmonary stenosis and 5 patients in XP-group underwent reoperation, but no patients in AP-group required balloon angioplasty or reoperation for
pulmonary stenosis. The risk factors influencing postoperative
pulmonary stenosis (sex, age at surgery, preliminary pulmonary artery banding, patch shape and material) were analyzed by multiple regression analysis. The patch material (heterologous patch) was the only identifiable risk factor for
pulmonary stenosis. These data suggest that pulmonary artery reconstruction with an autologous pericardial patch may be effective to prevent postoperative
pulmonary stenosis, although the long-term prognosis remains unknown.