[Arterial switch operation: late results and a future perspective].

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Disease
• Cardiovascular Surgery

Context:

• The arterial switch operation (ASO) is a primary surgical repair for d-transposition of the great arteries (TGA).
• Intermediate outcomes of ASO for various cardiac anomalies with TGA were evaluated.
• Long-term results and potential complications were assessed in survivors.

Purpose:

• To analyze the late results and identify problems following the arterial switch operation.
• To determine actuarial survival and event-free rates in patients undergoing ASO.
• To investigate risk factors for specific complications such as right ventricular outflow tract obstruction and aortic regurgitation.

Summary:

• Retrospective study of 75 ASO survivors (1991-2007) with a mean follow-up of 7.5 years.
• Achieved 97% actuarial survival and 83% event-free rate at 16 years.
• 93% of patients were medication-free with no activity restrictions; common issues included mild pulmonary stenosis and mild aortic regurgitation.

Impact:

• Identified risk factors for right ventricular outflow obstruction (DORV, aortic arch obstruction, prior PAB) and aortic regurgitation (age at operation, prior PAB).
• Suggests early primary ASO may mitigate long-term complications.
• Provides valuable data for surgical decision-making and follow-up strategies in pediatric cardiac surgery.