Results of arterial switch operation for primary total correction of the Taussig-Bing anomaly

Abstract

Background This study evaluates the results of the arterial switch operation for early total repair of double-outlet right ventricle with subpulmonary ventricular septal defect (the Taussig-Bing heart). Methods From 1986 through April 2003, 27 patients with Taussig-Bing anomaly underwent arterial switch operation. Twenty patients were neonates (n = 11) or infants younger than 3 months (n = 9). Obstruction of aortic arch (n = 19) or subaortic right ventricular outflow tract obstruction (n = 20) and unusual coronary artery patterns (n = 19) were common. Total correction as a single procedure was performed in 21 patients. Events are depicted by Kaplan-Meier curves. Results There was 1 patient hospital death at 2 months after repair. One patient died late that was not cardiac related. Survival was 92% ± 6% at 8 months and remained constant thereafter. Four patients underwent reoperation (1 for residual aortic arch obstruction and 3 for subvalvular and valvular pulmonary stenosis). Freedom from reoperation decreased to stabilize at 83% ± 8% after 2 years. The risk to have right ventricular outflow tract obstruction develop was 33% ± 10% at 1 year, increasing slowly and leveling out at 57% ± 12% at year 5 and thereafter. Statistical analysis revealed no significant risk factor for death or need for reoperation. Conclusions The Taussig-Bing anomaly should be corrected in the neonatal period or in early infancy by arterial switch operation, closure of the ventricular septal defect, and simultaneous correction of associated cardiovascular anomalies as a one-stage procedure. Right ventricular outflow tract obstruction often complicates the postoperative course and is the main cause for reintervention.