Mid-to-long term fate of neo-aortic root after arterial switch operation for Taussig-Bing anomaly:A retrospective study in a single center
Objective To explore growth pattern of neo-aortic root as well as development of neo-aortic regurgitation after arterialswitch operation(ASO)for Taussig-Bing anomaly.Methods From 2002 to 2017,the patients who received ASO,and were discharged alive from Shanghai Children's Medical Center and followed up for more than 3 years were retrospectively involved in this study.Results A total of 127 patients were enrolled.There were 98(77.2％)males,the median age at ASO was 73.0 d and the average weight was 4.7 kg.Forty-five(35.4％)children were complicated with mild or mild-to-moderate pulmonary insufficiency(PI)before ASO.The average follow-up time was 7.0 years.During the follow-up,14(11.0％)children presented moderate or greater neo-aortic regurgitation(neo-AR).The diameter of neo-aortic annulus and sinus of Valsalva was beyond normal range during the entire follow-up.The average diameter of neo-aortic annulus was 18.0 mm at 5 years and 20.5 mm at 10 years.The average diameter of sinus of Valsalva was 25.9 mm at 5 years and 31.1 mm at 10 years.Neo-AR continued to develop over time.The diameter of children who developed moderate or greater neo-AR was constantlylarger than that of children who did not(x2=18.3,P＜0.001).Preoperative mild or mild-to-moderate PI was an independent risk factor for the development of moderate or greater neo-AR during mid-to-long term follow-up(c-HR=3.46,P=0.03).Conclusion The diameters of neo-aortic annulus and sinus of Valsalva of Taussig-Bing children who receive ASO repair continue to expand without normalization.The dilation of annulus correlates with the development of neo-AR.PI before ASO repair increases the risk of neo-AR development.
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