Results of the arterial switch operation for Taussig-Bing variants in the setting of a lower-middle income country: a single institution experience

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.