OBJECTIVES: The arterial switch operation (ASO) is the method of choice for the Taussig-Bing heart. The aim of the study was to analyse the long-term outcome of correction of the Taussig-Bing heart. METHODS: Between 1986 and 2011, 44 infants, including 18 newborns, underwent an ASO. The staged and the primary approach were used in 9 and 35 patients, respectively. Aortic arch (AA) obstruction (n = 26) and right ventricle outflow tract obstruction (n = 34) were common. The mean age at corrective surgery was 112.9 days; the mean weight was 4.17 kg. RESULTS: There were 1 early and 4 late deaths. Overall survival was 88% at 15 years, with a mean follow-up of 9.2 years. Freedom from reoperation was 67% at 15 years of follow-up. Eight and 6 patients required right and left ventricular outflow tract surgery, respectively, including resection of the right ventricular outflow tract obstruction (n = 8), a transanular patch (n = 6), aortic valve reconstruction (n = 3), aortic valve replacement (n = 2) and AA reoperation (n = 4). Freedom from aortic regurgitation >mild or aortic valve replacement/reconstruction was 76% at 15 years of follow-up. Freedom from any event was 56% at 15 years of follow-up. All patients are in sinus rhythm, and biventricular function is well-preserved in 95% of patients. All patients are doing well; 86% of them are without medication. CONCLUSIONS: Corrective surgery offers excellent survival benefits and encouraging long-term functional outcomes, regardless of the coronary anatomy and associated lesions. Normal biventricular function is preserved in the vast majority of patients, and >3/4 of patients are without cardiac medication. Nevertheless, TBH associated with a complex anatomy continues to be a risk factor for long-term morbidity, and redos and reinterventions are equally common on both outflow tracts. Progressive neoaortic regurgitation and neoaortic root dilatation might be a problem in the future; therefore, close lifelong surveillance of patients is necessary.
OBJECTIVES: The arterial switch operation (ASO) is the method of choice for the Taussig-Bing heart. The aim of the study was to analyse the long-term outcome of correction of the Taussig-Bing heart. METHODS: Between 1986 and 2011, 44 infants, including 18 newborns, underwent an ASO. The staged and the primary approach were used in 9 and 35 patients, respectively. Aortic arch (AA) obstruction (n = 26) and right ventricle outflow tract obstruction (n = 34) were common. The mean age at corrective surgery was 112.9 days; the mean weight was 4.17 kg. RESULTS: There were 1 early and 4 late deaths. Overall survival was 88% at 15 years, with a mean follow-up of 9.2 years. Freedom from reoperation was 67% at 15 years of follow-up. Eight and 6 patients required right and left ventricular outflow tract surgery, respectively, including resection of the right ventricular outflow tract obstruction (n = 8), a transanular patch (n = 6), aortic valve reconstruction (n = 3), aortic valve replacement (n = 2) and AA reoperation (n = 4). Freedom from aortic regurgitation >mild or aortic valve replacement/reconstruction was 76% at 15 years of follow-up. Freedom from any event was 56% at 15 years of follow-up. All patients are in sinus rhythm, and biventricular function is well-preserved in 95% of patients. All patients are doing well; 86% of them are without medication. CONCLUSIONS: Corrective surgery offers excellent survival benefits and encouraging long-term functional outcomes, regardless of the coronary anatomy and associated lesions. Normal biventricular function is preserved in the vast majority of patients, and >3/4 of patients are without cardiac medication. Nevertheless, TBH associated with a complex anatomy continues to be a risk factor for long-term morbidity, and redos and reinterventions are equally common on both outflow tracts. Progressive neoaortic regurgitation and neoaortic root dilatation might be a problem in the future; therefore, close lifelong surveillance of patients is necessary.
Entities:
Keywords:
Arterial switch operation; Left ventricular outflow tract obstruction; Right ventricular outflow tract obstruction; Taussig-Bing anomaly; Transposition of the great arteries
Authors: Agata Bielecka-Dabrowa; Agata Bikiewicz; Marek Rybak; Filip Pawliczak; Joanna Lewek; Maciej Banach; Marek Maciejewski Journal: Clin Case Rep Date: 2021-12-06