Long-Term Results After Primary One-Stage Repair of Transposition of the Great Arteries and Aortic Arch Obstruction

Abstract

Infants with ventriculoarterial discordance and aortic arch obstruction represent a high-risk subgroup of candidates for an ASO. Despite a non-negligible operative mortality, single-stage primary repair represents the treatment of choice, and follow-up of operative survivors is favorable. Pericardial patch enlargement is a reliable technique for arch obstruction repair.

Outcomes and re-interventions after one-stage repair of transposition of great arteries and aortic arch obstruction

“…In contrast to some previous studies [12,13], there is an overall important need for re-intervention in half of the patients in our series. A similarly high rate for overall reinterventions of close to 43% was reported by Planché's group [9] with 19/67 patients (28%) requiring re-intervention for recurrent coarctation and 10/67 patients (15%) for neoaortic regurgitation.…”

“…A higher prevalence of initial and subsequent RVOTO was described in a similar series [12]. We adopted a routine division of prominent subvalvular trabeculations through the original aortic valve.…”

“…In many instances, this remains a major challenge in the context of unusual coronary artery anatomy with a dilated PA in a side-by-side arrangement. In the article by Pocar et al [12], complex coronary anatomy remains an important risk factor for this very difficult group of patients. However, in our series, transfer of unusual coronary patterns did not appear to be the direct cause of deaths.…”

A simple technique to circumvent the aorto-pulmonary size mismatch in arterial switch operation with arch repair: a report of five cases

“…However, no patient developed true and false aortic arch aneurysm after patch augmentation, in spite of the generous use of pericardium. [4] The pericardial tissue has been shown to potentially differentiate into arterial vascular wall. [5] Extended aortic reconstruction has given us good early results and we recommend its use in arterial switch operations with great arterial mismatch.…”

Estratégia cirúrgica na transposição das grandes artérias associada à obstrução do arco aórtico

“…The authors used it in cases of TGA associated with aortic arch interruption. Other authors recommend enlarging the aortic arch and ascending Aorta using a homograft [10] or autologous pericardium [11] to correct tubular hypoplasia. The translocation technique, apart from its application for both tubular hypoplasia of the aortic arch and aortic arch interruptions, is performed without using autologous or homologous patches that may calcify, causing complications in the future.…”