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Arterial Switch: How to Predict Reoperation

Carolina Rodrigues1, Rui Cerejo1

  • 1Hospital de Santa Marta, Portugal.

Revista Portuguesa De Cirurgia Cardio-Toracica E Vascular : Orgao Oficial Da Sociedade Portuguesa De Cirurgia Cardio-Toracica E Vascular
|April 28, 2018
PubMed

Insights

Pulmonary artery stenosis is the primary reason for reoperation after arterial switch (Jatene) surgery in patients with transposition of the great arteries. Coronary anomalies are the sole predictor of reoperation need.

Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease
  • Surgical Outcomes

Background:

  • Arterial switch operation (Jatene procedure) has been performed since 1989.
  • Evaluating outcomes is crucial for identifying reoperation causes and predictors.
  • This study focuses on outcomes following arterial switch for d-transposition of the great arteries (d-TGA).

Purpose of the Study:

  • To identify the main causes of reoperation after arterial switch surgery.
  • To determine variables that predict the need for reoperation in patients with d-TGA.
  • To analyze outcomes in a cohort of patients undergoing arterial switch at Santa Marta Hospital.

Main Methods:

  • Retrospective analysis of 91 patients with d-TGA.
  • Patients underwent arterial switch operation between 1999 and 2016.
  • Follow-up averaged 6 years (range 1-21 years).

Main Results:

  • Reoperation was required in 21% of patients, with pulmonary artery stenosis being the main indication (47%).
  • Overall cumulative mortality was 9.9%.
  • Coronary pattern anomalies were the only statistically significant predictor (P<0.05) of reoperation need in both univariate and multivariate analyses.

Conclusions:

  • Pulmonary artery stenosis is the leading cause for reoperation post-arterial switch.
  • The presence of coronary anomalies is the sole identified predictor for reoperation.
  • These findings aid in risk stratification and management of patients undergoing arterial switch for d-TGA.
Abstract

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