Cirugía de la transposición de las grandes arterias en periodo neonatal

Abstract

IntroductionTransposition of the great arteries (D-TGA) is one of the most common congenital heart diseases. The development of the arterial switch operation supposed a great achivement in the management of this pathology. Today it is a standardized technique with excellent results. In this study we seek to analyze the current status of the surgery for D-TGA in the neonatal period by reviewing our experience. MethodsRetrospective observational study. We included all patients who underwent arterial switch operation in our center between January 2007 and September 2020. Results74 patients underwent arterial switch operation. Overall mortality was 10.8% (15.6% in 2007-2012 and 7.1% in 2013-2020). 44.6% of the patients presented complex D-TGA. The presence of abnormal coronary patterns, associated malformations, or late surgery did not significantly increase mortality. The length of stay in ICU and hospital (median + interquartile range) was 10 (7-17) and 20 (14-30) days respectively.During the follow up period (mean follow-up of 5.3 ± 3.75 years) survival rate was 100%. Reoperation-free survival was 87.6% at 10 years. Reoperation rate was higher (p < 0.01) in patients with Taussig-Bing anomaly or coarctation of the aorta. ConclusionsThe arterial switch operation is considered of choice for the treatment of D-TGA in the neonatal period, due to its good perioperative and long-term results. These patients may require reinterventions, mainly due to right ventricular outflow tract obstruction and pathology of the neo-aortic valve and root.