Mid-term Morbidity and Mortality of Patients After Arterial Switch Operation in Infancy for Transposition of the Great Arteries

Puras, María José Rodríguez; Cabeza-Letrán, Luisa; Romero-Vazquiánez, Manuela; Soto, José Santos de; Hosseinpour, Reza; Fournier, Mauro Gil; Madrid, Antonio; González, Antonio; Pérez, Pilar; Gallego, Pastora

doi:10.1016/j.rec.2013.06.021

Cited by 14 publications

(23 citation statements)

References 21 publications

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“…Several groups have reported re-intervention rates ranging from 7 to 18 % [4,12], but with different followup interval times. Our results showed that TB diagnosis carries a greater risk of re-operation after ASO.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Patients After Arterial Switch Operation: 18 Years of Experience in a Single Medium-Volume Center

et al. 2015

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The objective of this paper was to describe the outcomes in patients submitted to arterial switch operation and to analyze the predictors of in-hospital mortality and further need of re-operation at a single-center institution. Between September 1995 and January 2014, 128 consecutive arterial switch operations were performed. Surgical mortality during this period was analyzed retrospectively, and a follow-up analysis of the survivors was conducted. Surgical era, cardiopulmonary bypass time (p = 0.001), and diagnosis category (p = 0.025) influenced in-hospital mortality. The estimated overall survival for the 91 hospital survivors was 96.8, 96.4, and 96.2 % at 5, 10, and 15 years, respectively. The median follow-up time was 67 months (range 0.71-222 months). Three patients (5 %) presented severe aortic regurgitation. Right ventricle outflow tract systolic gradient by echocardiography was above 60 mmHg in 2 %. Late re-interventions occurred in 12 (13 %) patients with mean time of 64 ± 34 months after the initial procedure. Actuarial freedom from re-interventions at 5, 10, and 15 years was 96.4, 69.7, and 61.9 %, respectively. Arterial switch operation remains the procedure of choice in patients with transposition of great arteries. It can be performed even in middle-volume institutions, leading to the same middle- and long-term outcomes of high-volume institutions. Early high mortality rate may occur due not only to learning curve, but also to cardiopulmonary bypass time and ventricular septal defect closure.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Patients After Arterial Switch Operation: 18 Years of Experience in a Single Medium-Volume Center

et al. 2015

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“…Approximately 30% of patients after Mustard or Senning repair develop atrial arrhythmias within 10 years,5 and 28%–40% within 30–35 years after surgery 12 13. With the advent of the arterial switch surgery that does not require atrial incisions, SVT incidence has dropped to approximately 5% 14 15…”

Section: Pathophysiology Of Svt In Achdmentioning

confidence: 99%

“…Modification of the Fontan procedure has already considerably improved arrhythmia-free survival 18 41 42. Likewise, the change from baffle surgery to arterial switch operation has markedly decreased arrhythmia burden in TGA patients 14 15…”

Section: Future Directionsmentioning

confidence: 99%

Management of supraventricular arrhythmias in adults with congenital heart disease

Wasmer

Eckardt

2016

Heart

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Supraventricular arrhythmias are a frequent complication in adults with congenital heart disease (ACHD). The prevalence increases with time since surgery, complexity of the underlying defect, type of repair and older age at surgery. Arrhythmias are the most frequent reason for hospital admission and along with heart failure the leading cause of death. The arrhythmia-associated increase in morbidity and mortality makes their management a key task in patients with ACHD. Intra-atrial re-entry is the most frequent arrhythmia mechanism. Less common arrhythmia mechanisms are supraventricular tachycardias in the presence of an accessory pathway, atrioventricular nodal re-entrant tachycardia or focal tachycardias. Patient management includes stroke prevention, acute termination and prevention of arrhythmia recurrence. Acute treatment depends on patients' symptoms. In cases of haemodynamic instability, immediate cardioversion is warranted. For stable patients, acute treatment includes rate control and termination by antiarrhythmic drugs or electrical cardioversion. Following a symptomatic arrhythmia, catheter ablation or treatment with antiarrhythmic drugs is recommended to prevent recurrences. Advances in mapping and ablation technology are now associated with high success rates of catheter ablation. In patients with a complex substrate recurrence rates of 50% remain high. However, in the presence of side effects and complications associated with long-term antiarrhythmic drug therapy, redo procedures are encouraged by current guidelines.

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“…The early outcome of arterial switch operation at the center was found comparable to the other well-established centers, which is contrary to what was observed in the literature review. The contemporary literature showed that the surgical outcome of arterial switch operation performed at the new centers is associated with higher morbidity and mortality [10][11][12]. The surgical outcome of ASO at the current center remained consistent over the last two and a half year.…”

Section: Discussionmentioning

confidence: 76%

Early Outcomes of Arterial Switch Operation Performed at a New Pediatric Cardiology Center in Mumbai

Trivedi¹,

Salvi²,

Chokhandre³

et al. 2019

IJCTS

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Introduction: The transposition of great arteries (TGA) is one of the main causes of neonatal or early infancy open heart surgeries in pediatric cardiology. The ASO is preferred over the Atrial switch when suitable as the left ventricle remains the systemic ventricle and there are fewer incidences of postoperative arrhythmias. Method: It's a retrospective review of the early surgical outcomes of arterial switch operation performed at the department of pediatric cardiology at Wockhardt Hospital, Mumbai Central, Mumbai from August 2014 to August 2017. Results: During the specified period, a total of 22 children were admitted to the hospital for ASO for TGA. The average age of the patient was 78 days. The mean weight of the children was 3.35 kg and height was 52.5 cm. Discussion: The early outcome of arterial switch operation at our center is as good as the other well-established centers. The surgical outcome of ASO remained consistent over the last two and a half year. The policy of our institution is to optimize the patients prior to the surgery, may need BAS if the children are of TGA with intact ventricular septum with restricted atrial level shunt group. Conclusion: The review shows the early results of postoperative cases of arterial switch operation from a new center are as encouraging as from the other high volume centers.

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Mid-term Morbidity and Mortality of Patients After Arterial Switch Operation in Infancy for Transposition of the Great Arteries

Cited by 14 publications

References 21 publications

Outcomes of Patients After Arterial Switch Operation: 18 Years of Experience in a Single Medium-Volume Center

Outcomes of Patients After Arterial Switch Operation: 18 Years of Experience in a Single Medium-Volume Center

Management of supraventricular arrhythmias in adults with congenital heart disease

Early Outcomes of Arterial Switch Operation Performed at a New Pediatric Cardiology Center in Mumbai

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