Early and long term outcome of the arterial switch operation for transposition of the great arteries: predictors and functional evaluation

Abstract

ASO remains the procedure of choice for the treatment of various forms of TGA with acceptable early and later outcome in terms of overall survival and free reoperation. Strong predictors for poor overall free-reoperation survival are complex TGA, VSD, coronary anomalies, aortic coarctation and LVOTO or moderate PAS. The pulmonary artery reconstruction using a single 'pantaloon patch' seems to offer less residual stenosis. Patients with a VSD and a significant mismatch between the neo-aortic root and distal aorta are at a higher risk for developing postoperative neo-AVI.

Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study

“…It is now clear that a certain percentage of patients will need further reintervention/ reoperation [10,15,[17][18][19], which in the majority of patients is on the right side of the heart, for neopulmonary stenosis either at the anastomosis site or at the pulmonary artery bifurcation (after the LeCompte maneuver) [7,9,10]. Less commonly, reoperations involve the left side of the heart, such as the neoaortic valve, the aortic root, the subaortic area, and the coronary arteries [4,5,9].…”

Noninvasive Assessment of Autonomic Cardiovascular Function in Patients after Arterial Switch Operation for Transposition of the Great Arteries

“…However, late death generally occurs during childhood and is exceedingly rare in adulthood [15]- [20]. Nevertheless, we cannot assume that the problem disappears when childhood is over.…”

“…Coronary complication is a serious clinical problem in patients who have had the ASO, and has been associated with late death [15]- [18]. However, late death generally occurs during childhood and is exceedingly rare in adulthood [15]- [20].…”

“…In the long-term, the main causes of death in patients with TGA who have had ASO seem to be myocardial ischemia and sudden death [15]- [20]. Efficient screening is thus important, especially since patients with denervated hearts may not experience any symptoms of myocardial ischemia.…”

Follow-up of our patients with transposition of the great arteries and arterial switch operation; comparison of simple and complex transposition cases

“…bulunması, operasyondan sternum açık çıkılması, triküspit anülüs Z değerinin düşük olması, anormal koroner patern bulunması, uzun CPB ve AoCC süresi bildirilmiştir (3,4,(7)(8)(9)(10)(11)(12) Çalışmamızda belirlenen küçük yaş ve mortalite arasındaki ilişki, özellikle Grup 2'de ön plandadır. Basit BAT'lı hastalarda geç operasyon (>3 hafta) mortalite açısından bilinen bir risk faktörüyken, hastalarımızda olduğu gibi, kompleks BAT'lı hastalarda geç operasyon avantajlı olabilir.…”