Surgery ot the transposition of great arteries in the neonatal period

Introduction: Transposition of the great arteries (D-TGA) is one of the most common congenital heart diseases. The development of the arterial switch operation supposed a great achivement in the management of this pathology. Today it is a standardized technique with excellent results. In this study we seek to analyze the current status of the surgery for D-TGA in the neonatal period by reviewing our experience. Methods: Retrospective observational study. We included all patients who underwent arterial switch operation in our center between January 2007 and September 2020. Results: 74 patients underwent arterial switch operation. Overall mortality was 10.8% (15.6% in 2007-2012 and 7.1% in 2013-2020). 44.6% of the patients presented complex D-TGA. The presence of abnormal coronary patterns, associated malformations, or late surgery did not significantly increase mortality. The length of stay in ICU and hospital (median + interquartile range) was 10 (7-17) and 20 (14-30) days respectively. During the follow up period (mean follow-up of 5.3 +/- 3.75 years) survival rate was 100%. Reoperation-free survival was 87.6% at 10 years. Reoperation rate was higher (p < 0.01) in patients with Taussig-Bing anomaly or coarctation of the aorta. Conclusions: The arterial switch operation is considered of choice for the treatment of D-TGA in the neonatal period, due to its good perioperative and long-term results. These patients may require reinterventions, mainly due to right ventricular outflow tract obstruction and pathology of the neo-aortic valve and root. (c) 2020 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).