Outcomes of arterial switch operation for Taussig-Bing anomaly versus transposition of great arteries and ventricular septal defect

Ersin Erek; Dilek Suzan; Selim Aydın; Okan Yıldız; Barış Kırat; I Halil Demir; Ender Ödemiş

doi:10.5606/tgkdc.dergisi.2019.17245

Outcomes of arterial switch operation for Taussig-Bing anomaly versus transposition of great arteries and ventricular septal defect

Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jun 19;27(3):266-273. doi: 10.5606/tgkdc.dergisi.2019.17245. eCollection 2019 Jul.

Authors

Ersin Erek¹, Dilek Suzan¹, Selim Aydın¹, Okan Yıldız², Barış Kırat³, I Halil Demir⁴, Ender Ödemiş⁴

Affiliations

¹ Department of Pediatric Cardiac Surgery, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey.
² Department of Pediatric Cardiac Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
³ Department of Anesthesiology and Reanimation, Acıbadem Atakent Hospital, Istanbul, Turkey.
⁴ Department of Pediatric Cardiology, Acıbadem Atakent Hospital, Istanbul, Turkey.

Abstract

Background: This study aims to present the outcomes of arterial switch operation for Taussig-Bing anomaly versus transposition of the great arteries and ventricular septal defect.

Methods: Between November 2010 and December 2016, a total of 100 consecutive arterial switch operations in 42 pediatric patients (25 males, 17 females; median age 17 days; range, 2 to 210 days) were performed in two centers. Among them, 42 patients had associated ventricular septal defect and were diagnosed with Taussig-Bing anomaly (n=15) or transposition of the great arteries and ventricular septal defect (n=27). Aortic arch anomalies were present in six patients (40%) with Taussig-Bing anomaly and two patients (7.4%) with transposition of the great arteries and ventricular septal defect (p=0.016). Coronary anomaly was observed in five (33.3%) and six (22.2%) patients, respectively. All patient had a large defect (multiple n=4), except for eight patients who had moderate defect in the transposition of the great arteries group.

Results: Early mortality was 13.3% in the Taussig-Bing anomaly group and 7.4% in the other group. Extracorporeal membrane oxygenation support was needed in three patients. Delayed sternal closure was used in most of the patients (92.9%). The median length of intensive care unit and hospital stays were similar between the groups. The median follow-up was 16 (range, 1 to 50) months. Two patients including one planned (debanding and multiple defect closure) and one unplanned (residual defect closure) were reoperated. Three patients needed aortic balloon angioplasty due to recoarctation and one patient underwent pulmonary balloon angioplasty. Overall reintervention rate was 18.4%.

Conclusion: Although the incidence of aortic arch and coronary anomalies were higher in patients with Taussig-Bing anomaly, early and mid-term results were similar. Based on these results, primary arterial switch operation seems to be successfully performed for both pathologies.

Keywords: Congenital heart disease; Taussig-Bing anomaly; neonate; transposition of great arteries; ventricular septal defect.