Mid-term Outcome and Risk Factor after Single Stage Repair of Arterial Switch Operation Combined with Aortic Arch Reconstruction

Truong L. Nguyen, Vinh Q. Tran, Mai T. Nguyen, Anh V. Doan, Duyen D. Mai, Hai T. Le

Children Heart Center, National Children Hospital, Ha Noi, Viet Nam

Date, time and location: 2018.05.25 13:30, Press Hall, 2F

Abstract

Objectives: Single stage repair is recently a procedure of choice for complex transposition of the great arteries (TGA) or Taussig-Bing anomaly combined with aortic arch hypoplasia (AAH) and coarctation of the aorta (CoA). This study is design to evaluate the mid-term outcome and risk factor for a surgical challenge in a developing country.

Methods: From February 2010 to December 2016, a consecutive 31 patients diagnosed with TGA (9 patients) or Taussig-Bing anomaly (22 patients) associated with aortic arch hypoplasia, coarctation of the aorta or interrupted aortic arch (IAA) underwent single stage repair. The aortic arch reconstruction was perform using autologous tissue and regional cerebral perfusion before arterial switch operation. In TGA group, there were 1 patient with intact ventricular septum (IVS) and CoA, 1 patient with ventricular septal defect (VSD) with CoA and AAH, 6 patients with VSD and CoA, and 1 patient with IAA. Taussig-Bing anomaly group showed 12 patients with CoA and AAH, 8 patients with discrete CoA, and two patients with IAA. Aortic cross clamp time was 172,32± 31,36 min and regional cerebral perfusion time was38,76 ± 12,30 min.

Results: There were 6 (19,4%) hospital deaths and no late deaths. Two patients (6,5%) required reoperation due to right ventricle outflow tract obstruction, and no patient required re-intervention for re-coarctation. Nosocomial infection is the only one significant risk factor for hospital mortality (p=0,036). Coronary artery pattern, CoA and others anatomic lesions is not a risk factor for death by multivariable analysis.

Conclusions: Single stage repair for complex TGA or Taussig-Bing anomaly can be performed with good results in developing country.