Abstract
Background: This study was conducted to evaluate the
surgical results of the arterial switch operation for Taussig-Bing
variants, at a single institution in a lower-middle income country.
Methods: Between June 2010 and December 2018, all
consecutive patients diagnosed with Taussig-Bing variants who underwent
the arterial switch operation and ventricular septal defect closure were
included in the study.
Results: A total of 72 patients of Taussig-Bing variants
who underwent arterial switch operation and ventricular septal defect
closure. There were 10 early deaths (13.9%) and 2 late deaths (2.8%).
Intraoperative ventricular septal defect enlargement [hazard ratio
(HR) 7.23, 95% confidence interval (CI) 3.1294-16.7167; P< 0.001], secondary aortic cross clamping (HR 28.38, 95% CI
4.8427-166.3484; P < 0.001), post-operative pneumonia
(HR 5.64, 95% CI 1.2724-24.9917; P = 0.023), and post-operative
sepsis (HR 5.28, 95% CI 1.3512-20.6553; p = 0.017) were risk factors
for overall mortality by competing risk analysis. Sixty patients
(83.3%) required septoparietal trabeculation division/resection during
the arterial switch operation in an attempt to avoid right ventricular
outflow tract obstruction. The reoperation rate for right ventricular
outflow tract obstruction at last follow up was 6% (3 patients). The
estimated freedom from reoperation for right ventricular outflow tract
obstruction at 1 year, 5 year and 9 year was 98.3%, 91.9% and 91.9 ,
respectively.
Conclusions: The results of arterial switch operation
for Taussig-Bing variants were satisfactory in the operative setting of
a lower-middle income country, and performing extensive septoparietal
trabeculation division might reduce the reintervention rate for right
ventricular outflow tract obstruction in these patients.
Keywords: Taussig-Bing variants, arterial switch operation,
right ventricular outflow tract obstruction
Abstract word count: 253 words