Atakan ATALAY, Uğur GÖÇEN

Early and mid-term results of the arterial switch operation: a 7-year, single-center experience

Amaç: Bu makalenin amacı tek merkezde arteriyel switch ameliyatı yapılan hastaların hastane mortalitesinin ve reoperasyon ihtiyacının nedelerini araştırdık. Büyük arter transpozisyonu ve Taussing bing anomalisi nedenisle arteriyel switch ameliyatı yapılan hastaların erken ve orta dönem sonuclarını ve 7 yıllık deneyimimizi değerlendirdik.Gereç ve Yöntem: Ocak 2009 ile Mayıs 2016 tarihleri arasında, Büyük arter transpozisyonu (TGA) ve Taussing Bing anomalisinde Arteriyel switch operasyonu (ASO) uygulanan 34 hasta bu retrospektif çalışmaya dahil edildi. Hastaların ameliyatları aynı cerrahlar tarafından yapıldı. Hasta bilgileri, cerrahi raporları ve ekokardiyografi raporları retrospektif olarak değerlendirildi. Medyan izlem süresi 1-7 yıl, 42.2 ay idi. Bulgular: Hastanede 2 (%5.9) ölüm olmuştur. Geç ölüm yaşayan 31 hastanın 1'inde (%2.9) meydana geldi. Bir hastaya (%2.9) yeniden girişim gerekti. Yeniden girişim gerektirmeme oranı 7 yılda %97 oldu. İki hastada (%5.9) takipte orta derecede neo-aortik yetmezlik görüldü ve bir hasta neo-pulmoner arter stenozu nedeniyle tekrar ameliyat edildi. Analizler gösterdi ki, kilo, kros-klemp zamanı, kardiyopulmoner by pass zamanı ve operasyondaki hastanın yaşı mortalitede güçlü faktörlerdir.Sonuç: Arteriyel switch operasyonları TGA'nın farklı formlarında kabul edilebilir erken ve orta dönem sonuçlarıyla uygulan bir tedavi prosedürüdür. Arteriyel switch operasyonu küçük hacimli merkezlerde dahi düşük mortalite riski ve tatminkar orta dönem sonuçlar ile uygulanabilmektedir

Arteriyel switch ameliyatı sonrası hastalarınizlemi: 7 yıllık tek merkez deneyimi

Purpose: The aim of this paper was to describe the outcomes in patients submitted to arterial switch operation and to analyze the predictors of in-hospital mortality and further need of re-operation at a single-center institution. We reviewed our 7-year experience with arterial switch operation (ASO) for transposition of the great arteries (TGA) or Taussig-Bing anomaly (TBA) to assess the early and mid-term outcomes. Material and Methods: Between January 2009 and May 2016, 34 consecutive patients who underwent ASO for TGA with IVS (intact ventricular septum), TGA with VSD (ventricular septal defect) and Taussing bing anomaly were included in this retrospective study. The patients performed by same surgeons .Patients charts, surgical reports and echocardiograms were retrospectively reviewed. Median follow-up time was ranged from 1 to 7 years, 42.2 months. Results: There were 2 (5.9 %) in-hospital deaths. Late deaths occurred in 1 ( 2.9 %) of 31 survivors. One patient (2.9 %) required reintervention. The freedom from reintervention rate was 97.0 % at 7 years respectively. Two patients (5.9 %) had developed moderate neo-aortic regurgitation during the follow-up and one patient underwent reoperation mainly for neo-pulmonary artery stenosis. The analysis showed that weight, cross clamp (CC) time, cardiopulmonary bypass (CPB) time, age of operation are the strong predictors for mortality. Conclusion: ASO is a procedure performed for the treatment of various forms of TGA with acceptable early and midterm outcomes.ASO also can be performed with a low risk of early mortality and satisfactory mid-term outcomes even in a small volume center

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