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Abstract
Objective: The arterial switch operation (ASO) has now become a routine treatment for patients with transposition of the great arteries (TGA). This study was conducted to evaluate the surgical results of ASO at Children Heart Center, National Children’s
Hospital, Hanoi, Vietnam.
Methods: From February 2010 to December 2016, a total of 304 patients underwent ASO at Children Heart Center have collected to this study.
Results: In the study group, the ratio of male/female was 225/79 (2.85/1). There were 149 patients (49%) TGA - intact ventricular septum, 106 patients (34.8%) TGAventricular septal defect, and 49 patients (16.2%) of double outlet of the right ventricle
- transposition’s type (Taussig - Bing variant). The mean age of the patients was 49.94 ± 47.43 days (1 - 320), the mean weight was 3.67 ± 0.77 kg (2.1 - 6.7). There were 156 patients (51.3%) performed atrial septostomy, 102 patients (33.6%) were infused with Prostaglandin E1 before surgery, and 2 patients underwent left ventricular training before ASO. In the study group, 28 patients (9.2%) have coarctation of the aorta or aortic arch hypoplasia, 3 patients (1%) have interrupted aortic arch, who underwent 1
stage repair with regional cerebral perfusion. The aortic cross clamp time was 131.43 ± 37.65 minutes (56 - 279), the bypass time was 191.96 ± 81.17 minutes (92 - 924). Four patients need ECMO support after surgery. 25 patients (8.2%) died in - hospital, 5 died
late after discharge (1.6%). There were 7 patients (2.3%) who required reoperation during follow - up after surgery, in a total of 225 patients monitored continuously after surgery (49 patients lost follow - up or did not re - examine). Multivariate logistic
regression analysis showed the prognostic risk factors of hospital mortality including the following factors: aortic arch anomaly (OR = 7.3); open sternum (OR = 5.9); lung infection (OR = 5.1); sepsis (OR = 30.9); liver failure (OR = 33.9); and postoperative
arrhythmias (OR = 5.6). The prognostic risk factors for reoperation are aortic arch anomaly (OR = 29.6).
Conclusions: Mid - term results of ASO in Children Heart Center-National Children’s Hospital are excellent. Further investigation is necessary.
References
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| Published | 14-01-2025 | |
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| Issue | No. 77 (2022) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.77.14 | |
| Keywords | Phẫu thuật chuyển vị động mạch, chuyển gốc động mạch, bất thường Taussig - Bing Arterial switch operation, transposition of the great arteries, Taussig - Bing anomaly |
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