The Taussig-Bing anomaly: long-term results†

Abstract

Corrective surgery offers excellent survival benefits and encouraging long-term functional outcomes, regardless of the coronary anatomy and associated lesions. Normal biventricular function is preserved in the vast majority of patients, and >3/4 of patients are without cardiac medication. Nevertheless, TBH associated with a complex anatomy continues to be a risk factor for long-term morbidity, and redos and reinterventions are equally common on both outflow tracts. Progressive neoaortic regurgitation and neoaortic root dilatation might be a problem in the future; therefore, close lifelong surveillance of patients is necessary.

Clinical outcomes of primary arterial switch operation in treatment of Taussig-Bing anomaly

“…[6,7] Primary repair has the advantage of avoiding multiple surgeries and also, with primary palliation, patients are exposed to a longer period of cyanosis and have the risk of developing heart failure, pulmonary vascular disease, and aortic insufficiency. [8] In cases with complex anatomy, prematurity, and preoperative complications Schwarz et al [7] proposed that a two-stage approach can still be preferable. However, there is still a limited of data about the time of surgery and patients requiring primary palliation.…”

“…[7] Recent series equivocally advocate the repair of the arch pathology on the same stage during the arterial switch operation. [6,7,10] The technique of aortic arch repair vary among different clinics and include end-toside repair, [7] integrating neoaortic stump into the arch anastomosis or aortic relocation, [10] and routine patch augmentation. [6] Our cohort is heterogeneous regarding the technique of the arch repair; mainly extended endto-end anastomosis and patch augmentation were the techniques applied based on the surgeons' preference.…”

“…In addition, subaortic right ventricular tract obstruction was reported in rates up to 75% in patients with Taussig-Bing anomaly, [7] although others reported lower rates around 15%. [6,8] In our study, the rate of preoperative subaortic stenosis was coincidentally lower (5%).…”

“…[7,8,10,12,14,16,17] Staged repair and higher weight, and coronary abnormalities were reported to be main risk factors for mortality. [13,17] Soszyn et al [8] attributed their decreased mortality to complete resection of sub-neoaortic obstruction and overall improvement of perioperative care.…”

“…[1] Although various alternative repair strategies have been developed through the years, [2][3][4][5] the closure of the ventricular septal defects (VSDs) tunneling the left ventricular outflow tract to the pulmonary valve followed by arterial switch operation was accepted as the method of choice, particularly in the past decade. [6][7][8][9][10] One of the concerns regarding the management has been the high coincidence of TaussigBing anomaly with aortic arch obstruction which was spotted early in the surgical experience. [11] The recent literature has addressed into the debate on whether the arch obstruction can be managed on the same stage as the Taussig-Bing repair or whether a staged approach is more suitable in selected cases.…”