Arterial switch operation - recent experience of 188 cases from a single institution

  • Dr Lyubomyr Bohuta, Ukrainian Children`s Cardiac Center, Ukraine
  • Dr Oleksandr Romaniuk, Ukrainian Children`s Cardiac Center, Ukraine
  • Dr Iryna Aksjonova, Ukrainian Children`s Cardiac Center, Ukraine
  • Dr Oleksandr Bablyak, Ukrainian Children`s Cardiac Center, Ukraine
  • Dr Igor Lebid`, Ukrainian Children`s Cardiac Center, Ukraine
  • Prof Illya Yemets, Ukrainian Children`s Cardiac Center, Ukraine

    • Objective. To evaluate our recent experience with arterial switch operation (ASO) for transposition of the great arteries (TGA).
    Methods. All patients undergoing an ASO at our institution from January 2006, to November 2008, were reviewed. During that period we performed 188 ASO`s. There were 119 patients with TGA-IVS (63.2%), 58 with TGA-VSD (30.9%) and 11 with TGA-CoA (5.9%). Taussig-Bing anomaly (n=9, 4.8%) was referred to the TGA-VSD group. Aortic arch anomalies (n=11) were managed during ASO in all cases. Eight patients underwent ASO after prior PA banding and systemic-to-pulmonary shunt for LV retraining. Coronary pattern other than usual was seen in 63 (33.5%) cases - circumflex from right in 36 (19.1%); single in 8 (4.3%); inverted coronaries in 11 (5.9%); intramural in 2 (1.1%), inverted circumflex and right in 6 (3.1%).
    Results. There were 8 hospital deaths (4.3%) with only 3 of them among last 120 cases. Coronary and aortic arch anatomy could not be shown to affect survival. Postoperative period was uncomplicated in 163 (86.7%) cases. Median ICU stay was 6.8 (range 4-38) days. There were 2 late deaths due to non-cardiac causes.
    Conclusions. In the current era ASO can be safely performed for both TGA-IVS and TGA-VSD. Complex anatomical patterns including unusual coronaries and aortic arch anomalies were not found to affect early survival in our study as well.