Short term outcome of Aorta and pulmonary artery and valve in Patients undergoing Arterial Switch Operation for Transposition of Great Arteries

Dr Rakesh Kumar; Prof Hemant Narayan Roy

Volume : VIII, Issue : III, March - 2019

Short term outcome of Aorta and pulmonary artery and valve in Patients undergoing Arterial Switch Operation for Transposition of Great Arteries

Dr Rakesh Kumar, Prof Hemant Narayan Roy

Abstract :

Objectives: The aim of this study was to evaluate the incidence of neo–aortic regurgitation (AR) after arterial switch operation (ASO) and the associated risk factors. Methods: Retrospective review of records of 289 patients undergoing arterial switch operation from 2005 to 2015 was performed along with echocardiographic examination of neo–aortic valve, ventricular function and associated risk factors. Results: Mean weight at operation was 3.5 ± 0.25 kg. 150 patients had associated ventricular septal defect (VSD) out of which 19 were Taussig–Bing type and remaining 139 patients had intact ventricular septum. At last follow up (4.82 ± 3.1; Range 1–11 years), 35 patients (12.1 %) had developed AR; 24 had trivial AR and 10 had mild AR while only 1 had moderate AR. Freedom from intervention for aortic valve after ASO was 100% after 10 years. On univariate logistic regression analysis, complex transposition of great arteries (TGA) (presence of VSD, associated abnormalities like TAPVC, arch anomalies) was found to be a risk factor for AR. Presence of left ventricular outflow tract obstruction (LVOTO), pre–operative Aorta– pulmonary artery size discrepancy and abnormal coronary artery anatomy were also significant risk factors for neo–aortic regurgitation. On multi–variate logistic regression analysis, presence of VSD, LVOTO, abnormal coronary artery anatomy and Aorta – pulmonary artery size discrepancy were significantly associated risk factors for neo–aortic regurgitation. Conclusions: In our experience, incidence of AR after ASO remains low. Development of AR is related to presence of complex TGA, pre–operative aorta pulmonary size discrepancy and abnormal coronary artery anatomy