Single-Stage Correction for Taussig-Bing Anomaly Associated With Aortic Arch Obstruction

Area of Science:

• Congenital Cardiac Surgery
• Pediatric Cardiology
• Medical Malformations

Background:

• Taussig-Bing anomaly and aortic arch obstruction are complex congenital heart defects.
• Approximately 50% of patients with Taussig-Bing anomaly also present with aortic arch obstruction.
• These co-occurring conditions pose significant surgical challenges in neonates.

Purpose of the Study:

• To evaluate the surgical outcomes of single-stage correction for neonates with both Taussig-Bing anomaly and aortic arch obstruction.
• To assess the short- and mid-term survival rates, morbidity, and reoperation requirements.
• To determine the feasibility and effectiveness of a one-stage surgical approach.

Main Methods:

• A retrospective analysis of 39 neonates undergoing single-stage arterial switch operation and aortic reconstruction between November 2006 and November 2015.
• Patients included those with Taussig-Bing anomaly and coarctation of the aorta (28) or interrupted aortic arch (11).
• Follow-up included echocardiography and assessment of functional status (New York Heart Association class).

Main Results:

• The study reported an in-hospital mortality of 3 and one late death, resulting in a short-term survival rate of 92.3% (36/39) and mid-term survival of 89.7% (35/39).
• Postoperative complications included recoarctation, outflow tract obstruction, pulmonary artery stenosis, and valve regurgitation.
• Eight patients required reoperation during follow-up (6-92 months) without mortality; all survivors were in good functional class (I or II).

Conclusions:

• Single-stage correction of Taussig-Bing anomaly with aortic arch obstruction in neonates demonstrates favorable short- and mid-term outcomes.
• The procedure is associated with good mobility and an acceptable reoperation rate.
• Optimal surgical strategy should be individualized based on coronary artery anatomy and the specific type of aortic anomaly.