One-stage repair of transposition complex and interrupted aortic arch in
children
Abstract
Background/Aim: A transposition complex with an interrupted aortic arch
(IAA) is rare and surgically challenging because of its anatomical
diversity and complexity. Herein, we aimed to present our 20-year
experience with one-stage arterial switch surgery associated with IAA
repair. Methods: From January 2000 to April 2017, 11 patients were
diagnosed with transposition complex and IAA and underwent one-stage
repair at our center. These patients were retrospectively reviewed. Two
patients had transposition of the great arteries, while the others had
double outlet right ventricles, of whom eight had subpulmonary
ventricular septal defects (Taussig-Bing anomalies), and one had a
non-committed ventricular septal defect. In terms of the IAA, three
patients underwent repair by extended end-to-end anastomosis, and one
16-mm prosthetic vascular graft was replaced in an elder patient. The
remaining patients underwent autologous pericardial patch enlargement.
All the variables were summarized and reported with descriptive
statistics. Results: Three early deaths occurred in this study. The
median follow-up time was approximately 5 years (range: 3 – 14 years).
No late deaths were reported. Only one patient required percutaneous
re-intervention for recurrent coarctation. Moderate aortic regurgitation
was observed in three patients. However, there was no requirement for
aortic valvuloplasty or valve replacement. One patient had more than
moderate tricuspid regurgitation. The other survivors are presently
healthy. Conclusions: Although one-stage repair for transposition
complex and IAA still has non-negligible mortality even in older
children, the late outcomes of survivors are acceptable. Owing to the
high rate of valve regurgitation, closer follow-up is necessary for
these patients.