Prediction of aortic and pulmonary anastomoses stenosis after arterial switch operation

Abstract

Objective To analyze the stenosis of aortic and pulmonary anastomosis after arterial switch operation ( ASO). Methods A retrospective review was performed on 228 patients who had an ASO for the complete transposition of the great arteries and intact ventricular septum (TGA/IVS).transposition with ventricular septum defect (TGA/VSD),double outlet right ventricular with subpulmonary VSD (Taussig-Bing) and stage-switch operation from 1999 to 2007. Data including hospital histories, operation records,echocardiograms( ECHO) before and after operation were collected. Mean follow-up time is (20.4 ±18.6) months (1 month, 88 months). We analyze the development of obstruction according to the flow velocity in echo reports into three groups: flow velocity 3 m/s. Results The proportion of aorta anastomosis flow velocity >3 m/s is different in Taussig-Bing, TGA/IVS, TGA/VSD and Stage-Switch (P =0.034). The flow velocity >3 m/s happens mostly in Taussig-Bing. The proportion of flow velocity ( >3 m/s) at pulmonary anastomosis (9.2% ) is higher than at aorta (3.1% ). The flow velocity at anastomosis is likely to increase if operation age is below 12 days. Six patients were reoperated on for stenosis of pulmonary anastomosis after ASO operation for outflow obstruction. Conclusion The proportion of pulmonary anastomoses stenosis is higher than aortic anastomoses stenosis after ASO operation. It is important that the patients after ASO operation must be followed-up termly to check the anastomosis of pulmonary and aorta. Key words: Transposition of great vessels; Cardiac surgical procedures; Postoperative complications