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Fricke TA, Buratto E, Weintraub RG, et al. Long-term outcomes of the arterial switch operation. J Thorac Cardiovasc Surg. 2021;163(1):212-219doi: 10.1016/j.jtcvs.2021.01.134.
Fricke, T. A., Buratto, E., Weintraub, R. G., Bullock, A., Wheaton, G., Grigg, L., Disney, P., d'Udekem, Y., Brizard, C. P., & Konstantinov, I. E. (2022). Long-term outcomes of the arterial switch operation. The Journal of thoracic and cardiovascular surgery, 163(1), 212-219. https://doi.org/10.1016/j.jtcvs.2021.01.134
Fricke, Tyson A, et al. "Long-term outcomes of the arterial switch operation." The Journal of thoracic and cardiovascular surgery vol. 163,1 (2022): 212-219. doi: https://doi.org/10.1016/j.jtcvs.2021.01.134
Fricke TA, Buratto E, Weintraub RG, Bullock A, Wheaton G, Grigg L, Disney P, d'Udekem Y, Brizard CP, Konstantinov IE. Long-term outcomes of the arterial switch operation. J Thorac Cardiovasc Surg. 2022 Jan;163(1):212-219. doi: 10.1016/j.jtcvs.2021.01.134. Epub 2021 Feb 11. PMID: 33715839.
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J Thorac Cardiovasc Surg. 2022 Jan;163(1):212-219. doi: 10.1016/j.jtcvs.2021.01.134. Epub 2021 Feb 11.

Long-term outcomes of the arterial switch operation.

The Journal of thoracic and cardiovascular surgery

Tyson A Fricke, Edward Buratto, Robert G Weintraub, Andrew Bullock, Gavin Wheaton, Leeanne Grigg, Patrick Disney, Yves d'Udekem, Christian P Brizard, Igor E Konstantinov

Affiliations

  1. Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
  2. University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia.
  3. Department of Cardiology, Perth Children's Hospital, Perth, Australia.
  4. Department of Cardiology, Women and Children's Hospital, Adelaide, Australia.
  5. Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia.
  6. Department of Cardiology, The Royal Adelaide Hospital, Adelaide, Australia.
  7. Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Melbourne Centre for Cardiovascular Genomics and Regenerative Medicine, Melbourne, Australia. Electronic address: [email protected].

PMID: 33715839 DOI: 10.1016/j.jtcvs.2021.01.134

Abstract

OBJECTIVES: The arterial switch operation (ASO) has excellent early outcomes in the modern era. We sought to determine the long-term outcomes in patients who underwent an ASO at a single institution.

METHODS: Patients who underwent an ASO between 1983 and 2015 were identified from the hospital database and retrospectively reviewed using hospital records.

RESULTS: From 1983 to 2015, 844 patients with a biventricular circulation underwent an ASO. There were 28 (3.3%, 28/844) early deaths. Follow-up was available for 94% (729/774) of local patients after hospital discharge. Median follow-up was 15 years (interquartile range, 8-20 years). There were 187 (26%, 187/729) patients with more than 20 years of follow-up and 95 (13%, 95/729) patients with more than 25 years of follow-up. Overall survival was 95% (95% confidence interval [CI], 94%-97%) at 10 and 25 years after the ASO. At 25 years after ASO, freedom from overall reintervention was 77% (95% CI, 73%-81%), freedom from reoperation on the neoaortic root or neoaortic valve was 92% (95% CI, 88%-95%), and freedom from coronary reoperation was 99% (95% CI, 98%-99.7%). Left ventricular (LV) systolic function was normal in 595 of 609 (98%) of patients who had LV function quantified at latest follow-up. Of the 95 patients with more than 25 years of follow-up after ASO, 6 (6.3%) had at least moderate neoaortic valve regurgitation (AR) and 8 (8.4%) had undergone replacement of the neoaortic valve.

CONCLUSIONS: Overall, survivors of ASO have excellent late survival and normal LV systolic function into adult life. However, AR and reoperation on the neoaortic valve remains an issue for older patients.

Crown Copyright © 2021. Published by Elsevier Inc. All rights reserved.

Keywords: arterial switch operation; transposition of the great arteries

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