OBJECTIVE

To assess the impact of prenatal diagnosis on immediate treatment outcomes in newborns with transposition of the great arteries (TGA) in a head cardiac surgery center of a country with a large territory and low population density.

MATERIAL AND METHODS

A retrospective analysis included 149 newborns with TGA treated at the National Research Cardiac Surgery Center between 2012 and 2020. Two patients died at the preoperative stage, 147 ones underwent arterial switch surgery. Comparative analysis was carried out in two groups: PreN group (diagnosed prenatally, n=89), PostN group (diagnosed postnatally, n=60). Bemographic, pre-, intra- and postoperative data, as well as immediate outcomes were evaluated: in-hospital mortality (for the entire cohort), 30-day postoperative mortality, morbidity, cumulative morbidity and hospital-stay (for postoperative patients).

RESULTS

About 59.7% of newborns with TGA were diagnosed prenatally. Newborns born in Astana (78.7% vs. 6.7%, p<0.001) and arterial switch procedures performed within the first week after birth (41.4% vs. 16.7%, p=0.01) prevailed in the PreN group. In both groups, the following outcomes were obtained: 30-day postoperative mortality 5.6% and 5% (p=0.7), in-hospital mortality 10.1% and 10% (p=0.7), incidence of complications 26.4% and 30% (p=0.7), cumulative morbidity 34.5% and 56.7% (p=0.01), respectively. Length of hospital-stay was similar.

CONCLUSION

Prenatal diagnosis of TGA in a country with large territory and low population density does not affect 30-day mortality after arterial switch surgery and in-hospital mortality in newborns with TGA. However, prenatal diagnosis can favor delivery of children near a cardiac surgery center, contributes to arterial switch surgery in the first week of life and also reduces cumulative morbidity.