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Outcomes after arterial switch operation (ASO) for dextro-transposition of the great arteries are favorable. Technical performance score (TPS) class 2 and 3 predict reinterventions, guiding closer patient follow-up.

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Cardiac Imaging

Background:

  • The arterial switch operation (ASO) has significantly improved outcomes for dextro-transposition of the great arteries since the 1980s.
  • Contemporary outcomes and predictors of late reinterventions following ASO require ongoing evaluation.

Purpose of the Study:

  • To review current outcomes after arterial switch operation (ASO) for dextro-transposition of the great arteries.
  • To identify predictors for late reinterventions after ASO.

Main Methods:

  • Retrospective review of patients undergoing ASO for dextro-transposition of the great arteries between 1997 and 2017.
  • Assignment of Technical Performance Score (TPS) class (1, 2, or 3) based on echocardiographic evaluation at discharge.
  • Multivariable Cox regression analysis to identify patient- and procedure-specific factors associated with postdischarge reinterventions.

Main Results:

  • Survival to hospital discharge was 98% among 598 patients.
  • Freedom from unplanned reintervention at 5 years was 99% for TPS class 1, 84% for class 2, and 30% for class 3.
  • TPS classes 2 and 3 were significant independent predictors of reintervention (HR 10.6 and 58.2, respectively).

Conclusions:

  • The arterial switch operation (ASO) is associated with low mortality at our center.
  • Technical Performance Score (TPS) classes 2 and 3 are key predictors of late reinterventions after ASO.
  • TPS serves as a valuable tool for identifying high-risk patients requiring closer follow-up.