The analysis of the risk factors in the arterial switch operation for treatment of D-transposition of the great arteries in one Pediatric Cardiac Center in Serbia

Abstract

Introduction. The arterial “switch” operation has been the operation of choice for children born with Dtransposition of the great arteries (D-TGA) for more than 30 years in countries with developed pediatric cardiac surgery program. After two decades of successful treatment of these children with the atrial “switch” corrections (Mustard or Senning operative techniques), the arterial “switch” operation (ASO) had been introduced as a routine technique in one pediatric cardiac center in Serbia. Objective. The aim of this study was the analysis of the identified risk factors involved with the ASO in the preoperative, operative and postoperative period and their impact on the survival of the operated children. Methods. A retrospective nonrandomized study of 52 operated patients with D-TGA by the ASO in the period between May 1, 2003 and December 31, 2011, divided into two groups. The data collection consisted of preoperative, operative and postoperative factors during the in-hospital stay and until the discharge from the hospital. Descriptive and differential statistical methods were used for analysis. Results. Ten individual risk factors were identified as significant for the immediate survival of children operated with the ASO technique. Conclusion. The arterial “switch” surgical operative technique is a complex neonatal/young infant procedure in which the preoperative status carried a significant risk as well as the surgical technique itself. These results differ from the results published throughout the world and are a representation of an evolutionary process of one center in Serbia starting the ASO procedure.

Keywords

• D-transposition of the great arteries (D-TGA)
• arterial “switch”
• risk factors