Midterm Outcome of Primary Arterial Switch Operation Beyond Six Weeks of Life in Children With Transposition of Great Arteries and Intact Ventricular Septum

Bisoi, Akshay Kumar; Ahmed, Tameem; Malankar, Dhananjay; Chauhan, Sandeep; Das, Shambunath; Sharma, Pranav; Saxena, Anitá; Boopathy, Nagendra S.

doi:10.1177/2150135113515487

Cited by 22 publications

(29 citation statements)

References 24 publications

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“…Primary ASO may be used in patients older than 2 months of age with only slight increase in early morbidity and mortality, with 5.7% requiring postoperative mechanical assistance in one study [70]. Other studies show comparable outcomes of the late ASO in children up to 8 years of age, with only a mild increase in morbidity and resource consumption [71–74]. Those undergoing the two-stage ASO fared the worst.…”

Section: The “Late” Asomentioning

confidence: 99%

D-Transposition of the Great Arteries

Villafañe

Lantin‐Hermoso

Bhatt

et al. 2014

Journal of the American College of Cardiology

239

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Objectives This paper aims to update clinicians on “Hot Topics” in the management of patients with d-transposition of the great arteries (D-TGA) in the current surgical era. Background The arterial switch operation (ASO) has replaced atrial switch procedures for D-TGA and 90% of patients now reach adulthood. Methods The Adult Congenital and Pediatric Cardiology Council (ACPC) of the American College of Cardiology assembled a team of experts to summarize current knowledge on genetics, prenatal diagnosis, surgical timing, balloon atrial septostomy (BAS), prostaglandin therapy (PGE), intraoperative techniques, imaging, coronary obstruction, arrhythmias, sudden death, aortic dilation and regurgitation (AR), neurodevelopmental (ND) issues and lifelong care of D-TGA patients. Results In simple D-TGA, 1) familial recurrence risk is low; 2) children diagnosed prenatally have improved cognitive skills compared with those diagnosed postnatally; 3) echocardiography helps to identify risk factors; 4) routine use of BAS and PGE may not be beneficial in some cases; 5) early ASO improves outcomes and reduces costs with a low mortality. Single or intramural coronary arteries remain risk factors; 6) post-ASO arrhythmias and cardiac dysfunction should raise suspicion of coronary insufficiency; 7) coronary insufficiency and arrhythmias are rare but associated with sudden death; 8) early and late-onset ND abnormalities are common; 9) AR and aortic root dilation are well tolerated; and 10) the aging ASO patient may benefit from “exercise-prescription” rather than restriction. Conclusions Significant strides have been made in understanding risk factors for cardiac, ND and other important clinical outcomes after ASO.

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Section: The “Late” Asomentioning

confidence: 99%

D-Transposition of the Great Arteries

Villafañe

Lantin‐Hermoso

Bhatt

et al. 2014

Journal of the American College of Cardiology

239

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“…Although an increased need for ECMO support has been reported in late ASO patients, this was not accompanied by an increase in mortality. Bisoi et al [5] reported 20% of ECMO support and 3.7% mortality in a series of 109 late ASO patients. However, late mortality was reported separately from primary disease.…”

Section: Discussionmentioning

confidence: 98%

“…The arterial switch procedure is a question of debate in patients with TGA/IVS after three weeks of age due to the LV structure and function loss. Recently, because of the potential medium-to long-term complications of these operative procedures, there has been an increase in reports of successfully performed arterial switch procedures after the 3 rd week of life with the aid of improvements in advanced life support systems [4,5] .…”

Section: Discussionmentioning

confidence: 99%

“…For the success of the primary ASO, the LV needs to adapt quickly to the high afterload postoperatively. Usually, an unfavorable LV geometry is accepted as a contraindication for primary ASO, but this is reported to be transient and can be treated by pharmacological means and ECMO support [5,7] . This change in LV shape is due to a low afterload, not an intrinsic change in the LV myocardial properties, and it is reversible [5,7] .…”

Section: Discussionmentioning

confidence: 99%

“…Different centers perform staged ASO or the Senning procedure [2,3] . Recently, successful arterial switch procedures were reported in elderly patients with the aid of technological improvements and advanced intensive care support [4,5] . In this report, a successful arterial switch procedure with extracorporeal membrane oxygenation (ECMO) support in a patient with TGA/IVS is presented.…”

Section: Introductionmentioning

confidence: 99%

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Late Arterial Switch Surgery Under ECMO Support in a Patient with Transposition of the Great Arteries with Intact Ventricular Septum: a Case Report

Haydın¹,

Öztürk²,

Yıldız³

et al. 2020

Braz J Cardiovasc Surg

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A 30-month-old male patient with transposition of the great arteries with intact ventricular septum (TGA/IVS) is presented. Arterial switch operation (ASO) was performed in the light of echocardiographic and angiographic findings. The patient remained under extracorporeal membrane oxygenation support for seven days postoperatively, and his cardiac functions returned to normal at the postoperative 10 th day. He was discharged at the postoperative 20 th day. The present case, which presents one of the most advanced ages at operation for TGA/IVS among previously reported cases, is used to discuss late ASO in this study.

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Thrombus formation in the heart following balloon atrial septostomy in transposition of great arteries

Talwar

Kumar

Ramakrishnan

et al. 2022

Indian J Thorac Cardiovasc Surg

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Thrombotic complications following balloon atrial septostomy (BAS) are unusual. We report a patient with thrombus formation at the site of BAS, extending into the inferior vena cava (IVC), following BAS for transposition of great arteries with intact ventricular septum (TGA-IVS). An urgent arterial switch operation (ASO) with removal of the thrombus was performed. Supplementary Information The online version contains supplementary material available at 10.1007/s12055-022-01331-4.

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Midterm Outcome of Primary Arterial Switch Operation Beyond Six Weeks of Life in Children With Transposition of Great Arteries and Intact Ventricular Septum

Abstract: Primary ASO can be safely performed in children with regressed ventricle, irrespective of age with encouraging results. The midterm results of these children are comparable in terms of survival and freedom from complications associated with preserved ventricle.

Cited by 22 publications

References 24 publications

D-Transposition of the Great Arteries

D-Transposition of the Great Arteries

Late Arterial Switch Surgery Under ECMO Support in a Patient with Transposition of the Great Arteries with Intact Ventricular Septum: a Case Report

Thrombus formation in the heart following balloon atrial septostomy in transposition of great arteries

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