Outcome of Arterial Switch Operation for Taussig-Bing Anomaly Versus Transposition of the Great Arteries And Ventricular Septal Defect

Ersin Erek ¹, Dilek Suzan ¹, Okan Yildiz ², Selim Aydin ¹, Barıs Kirat ¹, Ozgen I. Kocyigit ¹, Ibrahim H. Demir ¹, Ender Odemis ¹

¹ Acibadem Mehmet Ali Aydinlar University , Istanbul, Turkey; ² Istanbul Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey;

Date, time and location: 2018.05.26 08:30, Press Hall, 2F

Abstract

Background:Patients with Taussig-Bing anomaly (TBA) usually considered to have increased mortality and morbidity when compared to those with transposition of the great arteries and ventricular septal defect (TGA+VSD) afterarterial switch operation (ASO). In this report, outcomes of both pathologies were analyzed.

Methods: Between November 2010 and December 2016, 100 consecutive ASO was performed. Among them, 42 patients (44,6%) had associated VSD and was diagnosed as TBA (n=15)or TGA+VSD (n=27). There were 25 males (%59,5) and 17 females (% 40,5). Median ages of the patients were 17 days (2-210). Aortic arch anomalies were present in 6 patients in TBA (40%) and 2 (7.4%) in TGA+VSD group (p=0.016).Coronary anomaly was observed in 5 (33.3%) and 6 (22.2%) patients respectively. All patient had large VSD (multiple n=4) except 8 patients had moderate sized VSD in TGA+VSD group.

Results: Early mortality was 2 patients in both TBA and TGA+VSD group (13,3% vs 7,4% respectively). ECMO support needed in 3 patients..Delayed sternal closure was used in most of the patients (92.9%). Median intensive care unit and hospital stays were similar and 9 and 17 days respectively. All patients were followed upmean 16months (1 – 50 months). One planned (debanding and multiple VSD closure) and 1 unplanned reoperation (residual VSD closure) was performed. Three patients needed aortic balloon angioplasty due to recoarctation and 1 patient underwent pulmonary balloon angioplasty. Overall reintervention rate was 18.4% (23% for TBA; 16% for TGA+VSD group).

Conclusion: Although the incidence of aortic arch and coronary anomalies are higher in TBA group, early and mid-term results were similar. PrimaryASO may be successfully performed to both pathologies.