ARTERIAL SWITCH OPERATION: VARIABLES PREDICTING REOPERATION

Authors

  • Carolina Rodrigues Cardiac Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central
  • Manuel Silva Cardiac Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central
  • Rui Cerejo Cardiac Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central
  • Rui Rodrigues Cardiac Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central
  • José Fragata Cardiac Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central

DOI:

https://doi.org/10.48729/pjctvs.30

Abstract

Objectives: Jatene surgery or arterial switch is performed at our institution since the late nineties. We reviewed our results to identify the main causes of reoperation and, more importantly, to determine what variables predict the need for reoperation.

Methods: In this retrospective analysis were included all the 91 patients with d-TGA who underwent an arterial switch operation at our institution between 1995 and 2016.

Results: Mean follow-up was 10 years (range 5-25 years). Seventy-one percent of patients had simple TGA and 29% had complex TGA. The need of reoperation was 21% (n=19 patients). Right ventricle outflow tract obstruction was the main indication for reoperation (58%). The overall mortality was 9.9%. The gender (P= 0.8), diagnosis (simple or complex TGA) (P= 0,5) or the existence of palliative surgeries (P=0.9) were unable to predict the need for reoperation. The presence of anomalous coronary pattern was the only variable reaching statistical significance (P< 0.05), both in univariate and multivariate analysis.

Conclusions: In our series, the main indication for reoperation after arterial switch operation was right ventricle outflow tract obstruction and the only predictive variable was the presence of anomalous coronary pattern.

Downloads

Download data is not yet available.

References

T. Geva et al., “D-Transposition of the Great Arteries,” J. Am. Coll. Cardiol., vol. 64, no. 5, pp. 498-511, 2014.

C. D. Fraser, “The Neonatal Arterial Switch Operation: How I Teach It,” Ann. Thorac. Surg., vol. 102, no. 3, pp. 681-684, 2016.

S. H. Daebritz, G. Nollert, J. S. Sachweh, W. Engelhardt, G. Von Bernuth, and B. J. Messmer, “Anatomical risk factors for mortality and cardiac morbidity after arterial switch operation,” Ann. Thorac. Surg., vol. 69, no. 6, pp. 1880-1886, 2000.

E. M. Delmo Walter et al., “Onset of pulmonary stenosis after arterial switch operation for transposition of great arteries

with intact ventricular septum.,” HSR Proc. Intensive Care Cardiovasc. Anesth., vol. 3, no. 3, pp. 177-87, 2011.

Y. S. Chen et al., “Prediction of early pulmonary artery stenosis after arterial switch operation: The role of intraoperative transesophageal echocardiography,” Cardiology, vol. 109, no. 4, pp. 230-236, 2008.

I. S. Chiu et al., “Restoring the spiral flow of nature in transposed great arteries,” Eur. J. Cardio-thoracic Surg., vol. 37, no. 6,

pp. 1239-1245, 2010.

A. W. Lowry, O. O. Olabiyi, I. Adachi, D. S. Moodie, and J. D. Knudson, “Coronary artery anatomy in congenital heart

disease,” Congenit. Heart Dis., vol. 8, no. 3, pp. 187-202, 2013.

T. Tsuda, A. M. Bhat, B. W. Robinson, J. M. Baffa, and W. Radtke, “Operation for Transposition of the Great Arteries,”

vol. 79, no. November, pp. 2372-2379, 2015.

Downloads

Published

17-04-2021

How to Cite

1.
Rodrigues C, Silva M, Cerejo R, Rodrigues R, Fragata J. ARTERIAL SWITCH OPERATION: VARIABLES PREDICTING REOPERATION. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Apr. 17 [cited 2024 Mar. 28];27(3):199-201. Available from: https://pjctvs.com/index.php/journal/article/view/30

Issue

Section

Original Articles

Most read articles by the same author(s)