Postnatal Growth after Arterial Switch Operation in Infants with Transposition of Great Arteries (TGA) after Early Arterial Switch Operation

Presently, TGA, including complex forms, can be repaired using the arterial switch operation (ASO) with a low operative risk. However, concerns about the effect of neonatal deep hypothermic circulatory arrest (DHCA) and hypoxia may have negative effect on postnatal linear and brain growth.

Aim of the study: The objective of this study was to evaluate growth in infants with d-transposition of the great arteries (d-TGA) who underwent switch operation (anatomical correction) in the early neonatal period.

Patients and methods: Growth data (at birth and 1, 6, 12, and 18:24 months of age) were followed in12 infants with d-TGA who were operated without major complications. Measures of weight, height weight for length and head circumference were transformed into z scores and compared with normative (WHO) data for age and sex.

Results: At birth L Z score was 1SD. At birth one infant (1/12) had WAZ < -2 who improved to 0.22 after 18 months. Six patients crossed down WAZ by one SD or more during the 18 months after surgery. 18 months after surgery 2 infants had WAZ< -1.5. One infant had HCZ

Conclusion: Following anatomical correction for d-TGA in the early neonatal period, infant growth shows variable patterns. The W/L improved in the majority of infants and none of the infants had LSDS or HCZ < -2 at 18 months denoting normal linear growth , weight gain and head (brain) growth in these infants.