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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Long-term outcomes and reoperation spectrum after arterial switch operation (ASO) are not fully defined.
  • Limited data exist regarding reoperations following ASO in the literature.
  • This study reviews institutional experience with reoperations after ASO.

Purpose of the Study:

  • To define the long-term outcome and spectrum of reoperations after ASO.
  • To analyze indications, procedures, and survival rates for patients requiring reoperation post-ASO.

Main Methods:

  • Retrospective review of 32 patients undergoing reoperation(s) after ASO between January 1984 and January 2012.
  • Analysis of patient anatomy, pathologies, reoperation types, and timing.
  • Evaluation of early and late mortality, and freedom from reoperation rates.

Main Results:

  • The most common indications for reoperation were right-sided pathology (56.3%) and neoaortic root pathology (31%).
  • Pulmonary artery reconstruction occurred earlier than neoaortic intervention (5.4 vs 13.8 years).
  • Early mortality was 6.2%, with no late deaths; 15-year freedom from reoperation was 41%.

Conclusions:

  • Right-sided pathology and neoaortic root issues are primary drivers for reoperation after ASO.
  • Excellent late survival is observed post-ASO, with a low risk of late reoperation.
  • Lifelong medical surveillance is crucial for patients who have undergone ASO.