Single-stage arterial switch with aortic arch reconstruction for Taussig-Bing anomaly with aortic arch obstruction
10.3760/cma.j.issn.1001-4497.2018.12.003
- VernacularTitle:动脉调转联合主动脉弓部重建一期矫治Taussig-Bing畸形合并主动脉弓部梗阻性病变
- Author:
Minghui ZOU
1
;
Li MA
;
Yuansheng XIA
;
Shengchun YANG
;
Weidan CHEN
;
Xinxin CHEN
Author Information
1. 510623,广州医科大学附属广州市妇女儿童医疗中心心脏中心
- Keywords:
Taussig-Bing anomaly;
Aortic arch obstruction;
Right heart outflow tract obstruction;
Cardiac surgical procedures
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(12):717-720
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the surgical outcomes of single-stage arterial switch with aortic arch reconstruction for Taussig-Bing anomaly with aortic arch obstruction in a single institution of china.Methods The clinical data of 26 consecutive patients with Taussig-Bing anomaly or TGA and aortic arch obstruction undergoing single-stage arterial switch with aortic arch reconstruction in Guangzhou Women and Children's Medical Center from November 2009 to December 2015 were retrospectively reviewed,and the risk factors for re-intervention were analyzed.Results There were three in-hospital deaths,and the earlyterm survival rate was 88.5% (23/26).Follow-up data were available for all patients who survived the operation(range 24-103 months).There were two late deaths.Survival estimates for the entire cohort following surgery were 84% (95% CI:70%-98%) and 77% (95% CI:58%-96%) at 1 year and 5 years,respectively.Echocardiology showed three cases of aortic regurgitation,two cases of supra-aortic stenosis,one case of recoarctation,seven cases of right heart outflow tract obstruction,and two cases of moderate pulmonary regurgitation.Six patients required a re-intervention during the follow-up period with no mortality.Freedom from re-intervention were 90% (95% CI:78%-99%) and 59% (95% CI:32%-86%) at 1 year and 5 years,respectively.Freedom from re-intervention for right-sided outflow tract obstruction were 94% (95% CI:84%-99%)and 66% (95%CI:37%-95%) at 1 year and 5 years,respectively.All survivors remained in good condition(New York Heart association functional class Ⅰ or Ⅱ).Conclusion Single-stage arterial switch with aortic arch reconstruction for Taussig-Bing anomaly with aortic arch obstruction had favorable early-and mid-term outcomes.The incidence of right heart outflow tract obstruction is still higher.The optimal operative procedure should be chosen according to the long-term follow-up.