Background: This study was conducted to evaluate the surgical
results of the arterial switch operation for Taussig-Bing variants, at a
single institution in a lower-middle income country. Methods:
Between June 2010 and December 2018, all consecutive patients diagnosed
with Taussig-Bing variants who underwent the arterial switch operation
and ventricular septal defect closure were included in the study.
Results: A total of 72 patients of Taussig-Bing variants who
underwent arterial switch operation and ventricular septal defect
closure. There were 10 early deaths (13.9%) and 2 late deaths (2.8%).
Intraoperative ventricular septal defect enlargement [hazard ratio
(HR) 7.23, 95% confidence interval (CI) 3.1294-16.7167; P
< 0.001], secondary aortic cross clamping (HR 28.38, 95% CI
4.8427-166.3484; P < 0.001), post-operative pneumonia
(HR 5.64, 95% CI 1.2724-24.9917; P = 0.023), and post-operative
sepsis (HR 5.28, 95% CI 1.3512-20.6553; p = 0.017) were risk factors
for overall mortality by competing risk analysis. Sixty patients
(83.3%) required septoparietal trabeculation division/resection during
the arterial switch operation in an attempt to avoid right ventricular
outflow tract obstruction. The reoperation rate for right ventricular
outflow tract obstruction at last follow up was 6% (3 patients). The
estimated freedom from reoperation for right ventricular outflow tract
obstruction at 1 year, 5 year and 9 year was 98.3%, 91.9% and 91.9 ,
respectively. Conclusions: The results of arterial switch
operation for Taussig-Bing variants were satisfactory in the operative
setting of a lower-middle income country, and performing extensive
septoparietal trabeculation division might reduce the reintervention
rate for right ventricular outflow tract obstruction in these patients.
Reoperation for right ventricular outflow tract obstruction after arterial switch operation for transposition of the great arteries and aortic arch obstruction
