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Arterial switch operation for Taussig-Bing anomaly with aortic arch obstruction
Tai Fuchigami1, Masahiko Nishioka1, Atsuya Shimabukuro2
1Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.
Asian Cardiovascular & Thoracic Annals
|October 29, 2020
Summary
Midterm outcomes for Taussig-Bing anomaly with aortic arch obstruction show excellent results for both single-stage and staged surgical corrections. Both strategies yield similar valve diameter changes and regurgitation grades, with no hospital or late deaths.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
- Surgical Outcomes Research
Background:
- Taussig-Bing anomaly with aortic arch obstruction requires surgical correction.
- While single-stage correction is ideal, some patients undergo repair later in infancy.
- Evaluating midterm outcomes of different surgical strategies is crucial for these complex cases.
Purpose of the Study:
- To evaluate the midterm outcomes of different surgical strategies for Taussig-Bing anomaly with aortic arch obstruction in patients not corrected neonatally.
- To compare single-stage correction versus staged repair in terms of surgical time, mortality, reintervention, and valve function.
Main Methods:
- Retrospective analysis of seven patients undergoing arterial switch operation and intraventricular rerouting between 2007 and 2017.
- Patients were categorized into single-stage correction or staged repair groups (including prior pulmonary artery banding and aortic arch reconstruction).
- Midterm outcomes including operative time, mortality, reintervention, and neopulmonary/neoaortic valve function were assessed.
Main Results:
- Single-stage correction had a significantly shorter arrest time (162.3 min) compared to staged repair (206.3 min).
- No hospital or late deaths occurred; one patient in each group required aortic reintervention.
- Neoaortic valve diameter decreased post-surgery, with no significant difference in neopulmonary valve diameter changes between groups. No patient had more than mild valve regurgitation at follow-up.
Conclusions:
- Both single-stage and staged surgical correction strategies for Taussig-Bing anomaly with aortic arch obstruction demonstrate excellent midterm outcomes.
- The choice of surgical strategy does not significantly impact neopulmonary or neoaortic valve diameter changes or regurgitation grade.
- These findings support the efficacy of both approaches in managing this complex congenital heart defect.
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