Impact of prenatal diagnosis of transposition of the great arteries on postnatal outcome

Abstract

Objective: To assess the impact of prenatal diagnosis of transposition of the great arteries (TGA) on postnatal outcome.

Methods: Hundred and fifty-four patients with either simple (n = 101) or complex forms (n = 53) of TGA, diagnosed prenatally (G1, n = 88) or postnatally (G2, n = 66), who were admitted and underwent surgical correction in our centre between 1998 and 2014, were analysed.

Results: Prostaglandin E₁ (PgE₁) infusion and balloon atrial septostomy (BAS) were performed in the first 48 h after birth more commonly in G1. The hospital mortality rate for the whole group was 7.1%, higher for complex forms (13.2%) than for simple TGA (3.9%), (p = 0.034). The overall mortality rate was similar in G1 and G2. The mortality for simple TGA was higher when PgE₁ infusion and BAS were implemented after the first 48 h (p = 0.001). All deaths in G2 occurred in patients first receiving PgE₁ and BAS beyond 48 h. PgE₁ was initiated in the first 48 h in most patients (83%) with simple TGA postnatally diagnosed.

Conclusions: Adequate measures in the first 48 h after birth are essential to reduce the early mortality in TGA, especially in the simple form. This can be provided by prenatal diagnosis or by early neonatal clinical suspicion and prompt measures.

Keywords:

• Transposition of the great arteries
• prenatal diagnosis
• arterial switch operation
• outcome
• prostaglandin E1

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article