The Taussig-Bing anomaly: long-term results. Eur J Cardiothorac Surg 2013 Nov;44(5):821-7
Date
05/07/2013Pubmed ID
23644700DOI
10.1093/ejcts/ezt148Scopus ID
2-s2.0-84885704478 (requires institutional sign-in at Scopus site) 27 CitationsAbstract
OBJECTIVES: The arterial switch operation (ASO) is the method of choice for the Taussig-Bing heart. The aim of the study was to analyse the long-term outcome of correction of the Taussig-Bing heart.
METHODS: Between 1986 and 2011, 44 infants, including 18 newborns, underwent an ASO. The staged and the primary approach were used in 9 and 35 patients, respectively. Aortic arch (AA) obstruction (n = 26) and right ventricle outflow tract obstruction (n = 34) were common. The mean age at corrective surgery was 112.9 days; the mean weight was 4.17 kg.
RESULTS: There were 1 early and 4 late deaths. Overall survival was 88% at 15 years, with a mean follow-up of 9.2 years. Freedom from reoperation was 67% at 15 years of follow-up. Eight and 6 patients required right and left ventricular outflow tract surgery, respectively, including resection of the right ventricular outflow tract obstruction (n = 8), a transanular patch (n = 6), aortic valve reconstruction (n = 3), aortic valve replacement (n = 2) and AA reoperation (n = 4). Freedom from aortic regurgitation >mild or aortic valve replacement/reconstruction was 76% at 15 years of follow-up. Freedom from any event was 56% at 15 years of follow-up. All patients are in sinus rhythm, and biventricular function is well-preserved in 95% of patients. All patients are doing well; 86% of them are without medication.
CONCLUSIONS: Corrective surgery offers excellent survival benefits and encouraging long-term functional outcomes, regardless of the coronary anatomy and associated lesions. Normal biventricular function is preserved in the vast majority of patients, and >3/4 of patients are without cardiac medication. Nevertheless, TBH associated with a complex anatomy continues to be a risk factor for long-term morbidity, and redos and reinterventions are equally common on both outflow tracts. Progressive neoaortic regurgitation and neoaortic root dilatation might be a problem in the future; therefore, close lifelong surveillance of patients is necessary.
Author List
Schwarz F, Blaschczok HC, Sinzobahamvya N, Sata S, Korn F, Weber A, Asfour B, Hraska VAuthor
Viktor Hraska MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Aortic Valve InsufficiencyArrhythmias, Cardiac
Cardiovascular Surgical Procedures
Double Outlet Right Ventricle
Female
Humans
Infant
Kaplan-Meier Estimate
Male
Retrospective Studies
Treatment Outcome
Ventricular Outflow Obstruction