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Selective timing for the arterial switch operation.

Brian W Duncan1, Nancy C Poirier, Roger B B Mee

  • 1Department of Pediatric and Congenital Heart Surgery, The Children's Hospital at The Cleveland Clinic, Cleveland, Ohio 44195, USA. duncanb@ccf.org

The Annals of Thoracic Surgery
|April 28, 2004
PubMed
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Individualized arterial switch operations for infants with transposition of the great arteries yield excellent survival and follow-up outcomes. This approach optimizes results based on patient anatomy and clinical condition.

Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease
  • Surgical Outcomes Research

Background:

  • Arterial switch operation (ASO) is a critical intervention for congenital heart defects.
  • Tailoring ASO timing to individual patient anatomy and clinical status is essential for optimal outcomes.

Purpose of the Study:

  • To evaluate the outcomes of the arterial switch operation (ASO).
  • To assess the impact of individualized timing based on anatomy and clinical status.

Main Methods:

  • Retrospective review of 117 infants (<90 days old) undergoing ASO.
  • Analysis of patient data based on diagnosis (TGA with intact VSD, TGA with VSD/DORV, aortic arch anomalies) and age at repair.

Main Results:

Related Experiment Videos

  • Overall hospital mortality was 0.85% (1/117), with 1.7% total mortality at median 35-month follow-up.
  • 75% had TGA with intact VSD, repaired early; 30% had TGA with VSD/DORV, repaired based on heart failure severity.
  • 4% required re-intervention for issues like aortic coarctation or pulmonic stenosis.

    • Conclusions:

    • Individualized ASO timing within 90 days of life ensures excellent survival rates.
    • This approach is effective across diverse transposition physiologies.
    • Patients can expect a satisfactory clinical course post-operation.