PALLIATIVE ARTERIAL SWITCH OPERATION AS AN ALTERNATIVE FOR SELECTED
CASES: SINGLE CENTERS‘ EXPERIENCE AND MID TERM RESULTS
Abstract
ABSTRACT Introduction and Objective: There are various management
options for newborns with single ventricle physiology,
ventriculoarterial discordance and subaortic stenosis (SOS), classically
involving the early pulmonary banding and aortic arch repair, the
restricted bulboventriculer foramen(BVF) enlargement or the Norwood and
the Damus Kaye Stansel (DKS) procedures. The aim of this study is to
evaluate the midterm results of our clinical experience with palliative
arterial switch operation (pASO) for this subset of patients. Method: We
hereby retrospectively evaluate the charts of patients going through
pASO, as initial palliation through Fontan pathway, starting from 2014
till today. Results: 10 patients underwent an initial palliative
arterial switch procedure. 8 of 10 patients survived the operation and
discharged. 7 of 10 patients completed stage II and 1 patient reached
the Fontan completion stage and the other six of ten (6/10) patients are
doing well and waiting for the next stage of palliation. There are two
mortalities in the series (2/10) and one patient lost to follow-up
(1/10). Conclusions: The pASO can be considered as an alternative
palliation option for patients with single ventricle physiology,
transposition of the great arteries and systemic outflow obstruction. It
not only preserves systolic and diastolic ventricular function, but also
provides a superior anatomic arrangement for following stages. Keywords:
Congenital Heart Disease, Single Ventricle, Arterial Switch Operation