[Primary, single-stage arterial switch operations at a newly-established, comprehensive congenital cardiac center performed in the neonatal age and beyond]

Abstract

Introduction: Outcome of arterial switch operation for transposition of the great arteries with/without ventricular septal defect is a service key-performance-indicator.

Aim: The aim of the authors was to assess patient characteristics and parameters in the perioperative course.

Method: In the setting of a newly-established, comprehensive tertiary-care center, primary complete repair was performed including associated anomalies, e.g. transverse arch repairs. Patients with d-transposition were grouped according to coexistence of ventricular septal defect.

Results: 118 arterial switch operations were performed between 2007 and 2014 with 96.62% survival (114/118). Ventricular septal defect and repair of associated anomalies did not yield worse outcome. Left ventricular re-training with late presentation necessitated mechanical circulatory support for 4.5±1.5 days.

Conclusions: D-transposition is suitable for standardization of clinical algorithm and surgical technique. Quality standards contribute to excellent outcomes, minimize complications, and serve as blueprint for other neonatal open-heart procedures. Availability of mechanical circulatory support is key for single-stage left ventricular re-training beyond the neonatal period.

Keywords: infant; kimenetel; komplett nagyér-transzpozíció; newborn; postoperative complications/mortality; posztoperatív szövődmények/mortalitás; transposition of great vessels/surgery; treatment outcome; újszülött/csecsemő.