OC64 RESULTS OF PRIMARY ARTERIAL SWITCH OPERATION AFTER 21 DAYS OF AGE FOR TRANSPOSITION OF GREAT ARTERIES WITH INTACT VENTRICULAR SEPTUM

Abstract

Background and aim: Late arterial switch operation (ASO) for transposition of great arteries (TGA) with intact ventricular septum comes at higher post-operative risk if performed after 3 weeks of age due to left ventricle (LV) deconditioning. We aim to evaluate results of ASO performed after 21 days of life (late) in relation to repair performed in the first 21 days of life (early). Methods: Retrospective single center study in all patients with TGA and intact ventricular septum who underwent ASO (May 2004-February 2016). Patients were divided in early repair (age ≤ 21 days) and late repair (age > 21 days). Differences were assessed with Chi-squared, Man-Whitney test, and student t-Test accordingly to sample size and variable type. Results: Patients included were 137 (male = 93 pts); 55 patients (40%) were in the late repair group and 35 pts (63.7%) had “banana shaped” LV. In the early group (n = 82 pts) 3 pts (3.6%) had “banana shaped” LV. Overall hospital mortality was 8% (n = 11) with no statistical differences between the two groups (late = 5% vs. early = 10%, p = 0.364). In the late repair 13% required postoperative ECMO compared to 7.5% in the early repair although not statistically different (p = 0.295). Post-operative left ventricular dysfunction at discharge occurred in 6 patients with no differences among groups (p = 0.536). Conclusions: Arterial switch operation after 21 days of age can be achieved with good hospital survival although need of postoperative ECMO support is higher due to transitory LV dysfunction without impacting in patients survival.