Single-stage arterial switch with aortic arch reconstruction for Taussig-Bing anomaly with aortic arch obstruction / 中华胸心血管外科杂志

ABSTRACT

Objective To review the surgical outcomes of single-stage arterial switch with aortic arch reconstruction for Taussig-Bing anomaly with aortic arch obstruction in a single institution of china.Methods The clinical data of 26 consecutive patients with Taussig-Bing anomaly or TGA and aortic arch obstruction undergoing single-stage arterial switch with aortic arch reconstruction in Guangzhou Women and Children's Medical Center from November 2009 to December 2015 were retrospectively reviewed,and the risk factors for re-intervention were analyzed.Results There were three in-hospital deaths,and the earlyterm survival rate was 88.5％ (23/26).Follow-up data were available for all patients who survived the operation(range 24-103 months).There were two late deaths.Survival estimates for the entire cohort following surgery were 84％ (95％ CI70％-98％) and 77％ (95％ CI58％-96％) at 1 year and 5 years,respectively.Echocardiology showed three cases of aortic regurgitation,two cases of supra-aortic stenosis,one case of recoarctation,seven cases of right heart outflow tract obstruction,and two cases of moderate pulmonary regurgitation.Six patients required a re-intervention during the follow-up period with no mortality.Freedom from re-intervention were 90％ (95％ CI78％-99％) and 59％ (95％ CI32％-86％) at 1 year and 5 years,respectively.Freedom from re-intervention for right-sided outflow tract obstruction were 94％ (95％ CI84％-99％)and 66％ (95％CI37％-95％) at 1 year and 5 years,respectively.All survivors remained in good condition(New York Heart association functional class Ⅰ or Ⅱ).Conclusion Single-stage arterial switch with aortic arch reconstruction for Taussig-Bing anomaly with aortic arch obstruction had favorable early-and mid-term outcomes.The incidence of right heart outflow tract obstruction is still higher.The optimal operative procedure should be chosen according to the long-term follow-up.