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.