Late Correction of Transposition of the Great Arteries

Abstract

Introduction: Surgical correction of transposition of the great arteries (TGA) is usually performed in the first week of life. There is no consensus on surgical intervention for patients with a late diagnosis. Our study was designed to evaluate the early results of patients who underwent late-term correction based on surgical techniques. Patients and Methods: Our study included patients older than a month, who were operated on due to TGA between 2014 and 2019. Data on the postoperative hospital mortality and morbidity of these patients were examined. Results: The study enrolled 11 patients. Arterial switch operation (ASO) was performed in 36.3% (n= 4) of the patients, while an atrial switch operation was performed in 63.7%. After left ventricular (LV) training, ASO was performed in 25% (n= 1) of the patients. Extracorporeal membrane oxygenation (ECMO) support requirement was present in 36.4% (n= 4) of the patients due to postoperative low cardiac output. The mortality rate was 27.3% (n= 3). Of these deaths, 33.3% occurred among patients who had undergone Senning operations, while 66.7% occurred among those who underwent ASO (n= 1). While 66.7% (n= 2) of the mortality was due to low cardiac output, 33.4% was due to sepsis (n= 1). Conclusion: There is still no absolute consensus on the timing of surgical intervention in cases of TGA. ASO can be performed in cases with an increased need for ECMO and acceptable mortality among patients over one month of age. For patients with LV regression, two-stage ASO and atrial switch operations are alternative options.