Risk Factors Associated With Arterial Switch Operation for Transposition of the Great Arteries

Hernández, J.A. García; Valladares, Cristina Montero; López, Adoración I. Martínez; Parreño, A. Romero; Montero, Josefina Grueso; Carazo, Mauro Gil-Fournier; Cayuela, Aurelio; Abril, M. Loscertales; Santos, Aníbal Tovaruela

doi:10.1016/s1885-5857(06)60510-0

Cited by 6 publications

(3 citation statements)

References 20 publications

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“…[9] However, the length of the stay of postoperative patients in ICU in the first few years after arterial switch surgery in another center was reported to be longer and the length of stay in ICU decreased over time, as the experience of the center increased. [10] Since our center is a newly established center, we have been more cautious about discharging our patients from ICU and the hospital. From this point of view, the relatively prolonged stay in ICU is compatible with the literature.…”

Section: Discussionmentioning

confidence: 99%

Is arterial switch operation possible with neonatology-focused intensive care unit modality

Doyurgan¹,

Özdemir²,

Akdeniz³

et al. 2021

Turk Gogus Kalp Dama

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Background: In this study, we aimed to examine the feasibility of arterial switch operation and its perioperative management with neonatology-focused intensive care modality in a region of Turkey where the birth rate and the number of asylum seekers who had to leave their country due to regional conflicts are high. Methods: Between December 2017 and June 2020, a total of 57 patients (48 males, 9 females; median age: 12.2 days; range, 2 to 50 days) who were diagnosed with transposition of the great arteries in our clinic and underwent arterial switch operation were retrospectively analyzed. All patients were followed by the neonatologist in the neonatal intensive care unit during the preoperative and postoperative period. Results: Thirty-eight (66.7%) patients had intact ventricular septum, 16 (28.1%) had ventricular septal defect, two (3.5%) had coarctation of the aorta, and one (1.7%) had Taussig-Bing anomaly. Coronary artery anomaly was present in 14 (24.5%) patients. The most common complications in the intensive care unit were renal failure requiring peritoneal dialysis in seven (12.3%) patients, supraventricular tachyarrhythmia in six (10.5%) patients, and eight (14%) patients left their chests open. The median length of stay in intensive care unit was 13.8 (range, 9 to 25) days and the median length of hospital stay was 24.5 (range, 16 to 47) days. The overall mortality rate for all patients was 12.3% (n=7). The median follow-up was 8.2 months. A pulmonary valve peak Doppler gradient of ≥36 mmHg was detected in five patients (8.7%) who were followed, and these patients were monitored by providing medical treatment. None of the patients needed reoperation or reintervention. Conclusion: We believe that arterial switch operation, one of the complex neonatal cardiac surgery, can be performed with an acceptable mortality and morbidity rate with the use of neonatology-focused intensive care modality, which is supported by pediatric cardiology and pediatric cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Is arterial switch operation possible with neonatology-focused intensive care unit modality

Doyurgan¹,

Özdemir²,

Akdeniz³

et al. 2021

Turk Gogus Kalp Dama

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“…Technical difficulty in translocating is well identified in uncommon coronary artery patterns like single, intramural, double orifice originating from the same sinus of Valsalva and inverted coronary arteries [9,10] . Additionally, performing ASO in combination with other surgical steps to repair complex congenital heart lesions increases the challenge of coronary harvesting and translocation specially in redo surgeries [1][2][3][4][5][6][7] . A single common coronary ostium was present in 16 patients (2.2%) in one cohort study [11] , none of whom experienced early or late death.…”

Section: Discussionmentioning

confidence: 99%

“…He aimed to achieve biventricular repair for a complex case presented with TGA combined with hypoplastic aorta, interrupted aortic arch and ventricular septal defect (VSD) [1] . Nevertheless, there is still a risk of early and late coronary complications, particularly in patients with unusual coronary patterns or if the ASO is combined with other surgical steps to correct a complex congenital anomaly [2][3][4] . This report presents a case of successful management of an unexpected coronary artery complication after redo surgery for a complex congenital heart disease.…”

Section: Introductionmentioning

confidence: 99%

An Unusual Coronary Artery Complication after Surgery for a Complex Congenital Heart Disease: A Case Report

Zaher

2021

ijirms

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Background: Unexpected events in cardiac surgery may increase morbidity and mortality, which may be more complicated and difficult to manage especially in redo complex congenital heart surgery in children. This report presents a case of unusual coronary artery complication after redo surgery for a complex congenital heart disease. Case Presentation: A female baby with ventricular septal defect, transposition of great arteries and coarctation of the aorta, underwent coarctation repair and pulmonary banding in neonatal period then at one year old, she underwent arterial switch operation and ventricular septal defect repair. In the pediatric cardiac intensive care unit, she required high doses of vasoactive inotropic drugs and echocardiography revealed sever right ventricular dysfunction without significant gradients or shunts. Accordingly, a diagnostic cardiac catheterization was performed and the aortic angiography revealed that the right coronary artery was not inadvertently transferred into the neo -aortic root during the step of arterial switch operation. The surgeon declared that he came upon confounding factors during the intraoperative assessment, which led him to identify a single coronary artery. Immediate reoperation performed to translocate the non-transferred right coronary artery into the neo aortic root and postoperatively the case required extracorporeal membrane oxygenation till she stabilized, and she was discharged in an acceptable condition. Conclusion: Early diagnosis and management of any complications related to coronary artery during pediatric cardiac surgery could lower risk and achieve favorable outcome.

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Complete Transposition of the Great Arteries

Hoffman

2009

The Natural and Unnatural History of Congenital Heart Disease

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Risk Factors Associated With Arterial Switch Operation for Transposition of the Great Arteries

Cited by 6 publications

References 20 publications

Is arterial switch operation possible with neonatology-focused intensive care unit modality

Is arterial switch operation possible with neonatology-focused intensive care unit modality

An Unusual Coronary Artery Complication after Surgery for a Complex Congenital Heart Disease: A Case Report

Complete Transposition of the Great Arteries

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