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Does a prenatal diagnosis affect mortality and morbidity for neonatal arterial switch operation

Published online by Cambridge University Press:  06 January 2022

Osman Guvenc Open the ORCID record for Osman Guvenc [Opens in a new window] ,
Serdar Beken ,
Aysegul Inamlik ,
Eda Albayrak ,
Bahar Temur Open the ORCID record for Bahar Temur [Opens in a new window] ,
Serdar Basgoze ,
Selim Aydin ,
Murat Saygi ,
Ender Ödemiş  and
Ersin Erek
...Show all authors
Osman Guvenc*
Affiliation:
Department of Pediatric Cardiology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Serdar Beken
Affiliation:
Department of Neonatology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Aysegul Inamlik
Affiliation:
Department of Pediatrics, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Eda Albayrak
Affiliation:
Department of Pediatrics, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Bahar Temur
Affiliation:
Department of Cardiovascular Surgery, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Serdar Basgoze
Affiliation:
Department of Cardiovascular Surgery, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Selim Aydin
Affiliation:
Department of Cardiovascular Surgery, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Murat Saygi
Affiliation:
Department of Pediatric Cardiology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Ender Ödemiş
Affiliation:
Department of Pediatric Cardiology, Koc University Medical Faculty, Istanbul, Turkey
Ersin Erek
Affiliation:
Department of Cardiovascular Surgery, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Ayse Korkmaz Toygar
Affiliation:
Department of Neonatology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
*
Author for correspondence: O. Guvenc, Department of Pediatric Cardiology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey. E-mail: [email protected]
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Abstract

Background:

The effect of prenatal diagnosis on prognosis in patients with transposition of the great arteries is not clear. In this study, we compared the outcomes after arterial switch operation.

Methods:

Outcome of 112 patients who had arterial switch operation in the neonatal period were analysed. The patients were divided into two groups: those who had prenatal diagnosis (Group 1; n = 34) and those who did not (Group 2; n = 78). The patients were also classified based on their diagnosis: simple transposition, transposition with ventricular septal defect and/or aortic arch hypoplasia, and Taussig–Bing anomaly.

Results:

In Group 1, the C-section delivery rate was higher (82% vs. 44%; p = 0.004), and it was observed that patients in Group 1 were more often intubated upon admission to the neonatal ICU (38% vs. 9%; p = 0.005). No differences were found between the two groups in terms of operation time, cardiopulmonary bypass time, post-operative invasive respiratory support duration, or extracorporeal membrane oxygenation support. It was observed that those who had Taussig–Bing anomaly had a higher mortality.

Conclusions:

Timely treatment have a positive effect on neonatal mortality and morbidity. That’s why all families with prenatal diagnosis of critical CHD should be recommended to have the delivery in a tertiary care hospital. Although it could not be demonstrated in this study, prenatal diagnosis has a potential to improve surgical results especially in countries or cities, which does not have enough resources for transfer and surgical units. Further efforts are needed to improve prenatal screening programmes.

Keywords

Arterial switch operationprenatal diagnosistransposition of great arteriesTaussig–Bing anomalynewborn
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 10 , October 2022 , pp. 1644 - 1648
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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