Results of the arterial switch operation for Taussig-Bing variants in
the setting of a lower-middle income country: a single institution
experience
Abstract
Background: This study was conducted to evaluate the
surgical results of the arterial switch operation for Taussig-Bing
variants, at a single institution in a lower-middle income country.
Methods: Between June 2010 and December 2018, all
consecutive patients diagnosed with Taussig-Bing variants who underwent
the arterial switch operation and ventricular septal defect closure were
included in the study. Results: A total of 72 patients
of Taussig-Bing variants who underwent arterial switch operation and
ventricular septal defect closure. There were 10 early deaths (13.9%)
and 2 late deaths (2.8%). Intraoperative ventricular septal defect
enlargement [hazard ratio (HR) 7.23, 95% confidence interval (CI)
3.1294-16.7167; P < 0.001], secondary aortic cross
clamping (HR 28.38, 95% CI 4.8427-166.3484; P <
0.001), post-operative pneumonia (HR 5.64, 95% CI 1.2724-24.9917;
P = 0.023), and post-operative sepsis (HR 5.28, 95% CI
1.3512-20.6553; p = 0.017) were risk factors for overall mortality by
competing risk analysis. Sixty patients (83.3%) required septoparietal
trabeculation division/resection during the arterial switch operation in
an attempt to avoid right ventricular outflow tract obstruction. The
reoperation rate for right ventricular outflow tract obstruction at last
follow up was 6% (3 patients). The estimated freedom from reoperation
for right ventricular outflow tract obstruction at 1 year, 5 year and 9
year was 98.3%, 91.9% and 91.9 , respectively.
Conclusions: The results of arterial switch operation
for Taussig-Bing variants were satisfactory in the operative setting of
a lower-middle income country, and performing extensive septoparietal
trabeculation division might reduce the reintervention rate for right
ventricular outflow tract obstruction in these patients.