1 Introduction
The arterial switch operation (ASO) with ventricular septal defect closure (VSD closure) has become the procedure of choice for Taussig-Bing variants (TBV) repair (1, 2). Additionally, single-stage total correction might provide better outcomes for these patients with aortic arch hypoplasia or coarctation of the aorta (Ao) (3-5). In the literatures, the short-term and midterm survival outcomes of these patients after the surgical repair of this complex congenital heart disease (CHD) have been excellent (5, 6).
However, TBV patients have a high rate of reoperation or reintervention after the ASO, especially related to the development of right ventricular outflow tract obstruction (RVOTO) (7, 8). The risk factors for RVOTO after ASO are side-by-side great arteries, aortic arch obstruction, coronary artery anomalies, preoperative presence of subaortic obstruction, and preoperative diagnosis of TBV (8, 9).
In this study, we investigated the surgical outcome and risk factors for mortality after the ASO for TBV patients at a single institution from a lower-middle income country (LMIC), and in particular describe our surgical techniques related to RVOT reconstruction by prophylactic resection of the septoparietal trabeculations (SPT), and evaluation of RVOT during follow-up.