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G158(P) The outcome of arterial switch operation for d-TGA in relation to comprehensive aristotle score
  1. M Ruhaiyem1,
  2. N Alalem1,
  3. R Shafi2,
  4. R Abu Suliman2,
  5. M Elbarbari1,2,3
  1. 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  2. 2Pediatric Cardiology, King Abdulziz Medical City/National Guard Health Affairs, Riyadh, Saudi Arabia
  3. 3Reasearch Centre, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia

Abstract

Introduction Transposition of great arteries (d-TGA) is a cyanotic congenital heart disease where the aorta and pulmonary artery are switched. The arterial switch operation (ASO) has become the standard for TGA. Morbidity and mortality depend upon factors such as the anatomy of the defect, ICU length of stay (LOS) and others. Comprehensive Aristotle Score (CAS) is used to predict outcome in patients. In a similar study published in 2012 that used CAS, morbidity was significantly higher in complex ASO.

This study aims to determine the morbidity and mortality factors in patients with d-TGA who underwent ASO using CAS.

Methods This is a retrospective cohort study in the paediatrics cardiology department. A total of 133 paediatric patients with d-TGA who had ASO were reviewed (2001–2013). Morbidity and mortality were measured based on existing CAS parameters. Those parameters were divided into: preoperative, intraoperative and postoperative, with a basic score of 10.0 for the ASO. Inferential statistics were applied using student t-test to compare continuous variables, and Chi-square for categorical variables. Statistical tests were declared significant at α level of 0.05 or less and the study was powered to 0.8.

Results About 66.9% (89) were males. Mean age was 11.5 ± 4.6 days, mean weight 3.1 ± 0.4Kg. Mean mechanical ventilation duration was 146.8 ± 265.2 h. Mean LOS was 13.5 ± 20.7 days. Among patients preoperatively, 24.8% (33) had ≥1 major complication (major) and 49.6% (66) had ≥1 minor complication (minor). Patients with ≥1 of either complication had significant correlation with ventilation time (P-value 0.000). ICU LOS affected both groups (P-value 0.002) for ≥1 minor, (P-value 0.003) for ≥1 major. Among patients postoperatively, 21.1% (28) had ≥1 major and 66.7% (88) had ≥1 minor. Similarly to preoperative results, both ventilation time and ICU LOS were significantly linked (P-value 0.000) to patients with ≥1 of either complication. Operative mortality was at 2.3% (3).

Conclusion In this study, morbidity was significantly higher in patients with major/minor peri/postoperative complications. Relationship between postoperative major complications and continuous risk factors were studied as well with no significant correlation.

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