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Cardiac outcome up to 15 years after the arterial switch operation

Sharon H Wong1, Kirsten Finucane, Alan R Kerr

  • 1Green Lane Paediatric and Congenital Cardiac Service, Starship Children's Hospital, Auckland, New Zealand.

Heart, Lung & Circulation
|August 3, 2007
PubMed

Insights

The arterial switch operation (ASO) offers good survival rates for infants with transposition of the great arteries (TGA) or double outlet right ventricle. Early mortality is linked to the ASO year and VSD, while late mortality relates to great artery configuration.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Cardiac Outcomes Research

Background:

  • Transposition of the great arteries (TGA) and double outlet right ventricle are critical congenital heart defects.
  • The arterial switch operation (ASO) is a primary surgical repair for these conditions.
  • Assessing long-term outcomes and mortality risk factors after ASO is crucial for patient management.

Purpose of the Study:

  • To evaluate the cardiac outcomes following the arterial switch operation (ASO) in infants.
  • To identify risk factors associated with mortality in infants undergoing ASO.
  • To analyze survival rates and predictors of morbidity after ASO for TGA and double outlet right ventricle.

Main Methods:

  • A retrospective review of 244 infants undergoing ASO at Green Lane Hospital.
  • Detailed analysis of preoperative assessment, operative management, and postoperative outcomes.
  • Statistical analysis to identify predictors of early and late mortality and re-intervention.

Main Results:

  • Postoperative survival rates at 1, 5, and 15 years were 85%, 84%, and 83%, respectively.
  • Calendar year of ASO and presence of a ventricular septal defect (VSD) predicted early mortality.
  • Late mortality was associated with a side-by-side great artery configuration; prolonged bypass time increased re-intervention rates.

Conclusions:

  • The arterial switch operation (ASO) can achieve low early and late morbidity and mortality.
  • Definitive repair using ASO is effective for infants with TGA or double outlet right ventricle.
  • Risk factor identification aids in optimizing surgical strategies and postoperative care.
Abstract

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