Outcomes of the Arterial Switch Operation in Patients With Taussig-Bing Anomaly

Natalie Soszyn, Tyson Fricke, Gavin Wheaton, James Ramsay, Yves d'Udekem, Christian Brizard, Igor Konstantinov

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    27 Citations (Scopus)

    Abstract

    Background: The arterial switch operation (ASO) is associated with poorer outcomes in patients with Taussig-Bing anomaly (TBA) compared with transposition of the great arteries (TGA). We describe the outcomes after ASO in patients with TBA at a single institution. Methods: Between 1983 and 2009, 57 patients with TBA underwent the ASO at the Royal Children's Hospital in Melbourne. Results: Hospital mortality was 5.3% (3 of 57). Larger weight at operation (p = 0.015), pulmonary artery banding prior to ASO (p = 0.049) and concurrent pulmonary artery banding (p = 0.049) were risk factors of early death. Actuarial survival was 94% at 15 years. Follow-up was 84% complete with a mean follow-up of 9.8 ± 6.7 years (range, 6 days to 19.1 years). There was no late mortality. Reintervention was required in 24.4% (11 of 45). Longer cross-clamp time (p = 0.027) was a risk factor for reintervention. Freedom from reintervention was 75.3% at 15 years. After ASO, 2.2% (1 of 45) presented with sub-neopulmonary obstruction and 13.3% (6 of 45) had moderate or more neoaortic insufficiency (neo-AI). Surgery prior to ASO was a risk factor for sub-neopulmonary obstruction (p = 0.049) and moderate or more neo-AI (p = 0.016). Freedom from moderate or more neo-AI was 91.1% at 10 years. Conclusions: Early mortality has improved over time with no mortality occurring in the last decade. Although patients are doing well on late follow-up, many patients require reintervention and show progression of neo-AI. Close long-term follow-up is warranted as patients are likely to require further reintervention in the second decade after TBA repair.

    Original languageEnglish
    Pages (from-to)673-679
    Number of pages7
    JournalAnnals of Thoracic Surgery
    Volume92
    Issue number2
    DOIs
    Publication statusPublished - Aug 2011

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