Demographic, Anatomic, and Outcome Survey in Patients With Arterial Switch Operation

Background: Complete transposition of the great arteries (TGA) is the second most common cyanotic congenital heart disease (CHD). Arterial switch operation (ASO) is now the standard surgical procedure for complete TGA. The present study is an analytical overview of the results of ASO. Methods: In this retrospective study, all cases of ASO at our tertiary care center between June 2010 and June 2013 were included. Demographic, anatomic, and intraoperative data were extracted from medical files and mortality and morbidity rates were calculated. Results: One hundred consecutive patients (67% male, mean age = 3.5 mon) were included. The most common subtype of CHD was TGA+VSD+PDA in 52%, and the most common position of the coronary artery was seen in 1L; 2RCx (17%). The global mortality rate was 20%, with the respective highest rates in the Taussig-Bing subtype (50%), in the patients with a history of balloon septostomy (48%), and in the cases with preoperative prostaglandin E1 therapy (49%) (P > 0.05). Prolonged mean preoperative CCU stay, prolonged mean postoperative intubation period, and prevalence of severe postoperative mitral regurgitation were significantly higher in the expired group (P < 0.05). Conclusions: This study showed a relatively high mortality rate in the patients undergoing ASO, in comparison to similar evidence, while the morbidity rate in the surviving patients was acceptable. Proper parallel circulations, timing of the surgery, and adequate skills among surgeons are essential for the success of ASO.