SURGICAL RESULTS OF ARTERIAL SWITCH OPERATION FOR PATIENTS WITH TRANSPOSITION OF THE GREAT ARTERIES-INTACT VENTRICULAR SEPTUM AT VIETNAM NATIONAL CHILDREN’S HOSPITAL FROM YEARS OF 2010-2016

Nguyễn Lý Thịnh Trường1,, Nguyễn Tuấn Mai1
1 Children Heart Center, Vietnam National Children's Hospital

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Abstract

Objective: The mid-term outcomes of arterial switch operation (ASO) for children who have transposition of the great arteries-intact ventricular septum (TGA-IVS) and risk factors associated with mortalities after surgery were evaluated. Methods: From April 2010 to December 2016, all patients diagnosed with TGA-IVS, who underwent ASO at Heart Center-Vietnam National Children Hospital wereretrospectively studied. Multivariate logistic regression analysis was performed to identify the risk factors for hospital mortality. Results: A total of 149 patients were collected to this study. The operation mean age and mean weight was 30,32±23,04days (3-163), and 3,46 ±0,6 kg (2.1-6.0), respectively. There were 2 patients required left ventricular training before ASO with unprepared left ventricle. The mean aortic cross-clamp time and mean bypass time were 113,47±28,61 min, and 172,52± 52,74min, respectively. There were 3 patients need ECMO support after surgery. 8 patients (5.4%) died in hospital and 3 late death (2%). No reoperation appears during the meantime follow-up of 22.88 ±17.48months (0.5-84). Multivariate logistic regression analysis revealed that pneumonia (OR=22.1) and sepsis (OR=51.9) were the risk factors of hospital mortality for patients with TGA-IVS after ASO. There was no significant difference in mortality between group of neonates and group of late presentation more than 30 days old (p=0.484). Conclusions: Results of ASO for patients diagnosed with TGA-IVS at Heart Center-Vietnam National Children Hospital are safe. Primary ASO is a good option to be considered and can be safely performed with individual patientswho presented with late presentation.

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