OBJECTIVE

To assess the impact of the place of birth and transportation of newborns with transposition of the great arteries (TGA) on perioperative status; to investigate the impact of restrictive patent foramen ovale (PFO) on transportability of these patients.

MATERIAL AND METHODS

A retrospective case-control study included 149 consecutive newborns with TGA between 2012 and 2020. Two patients died at the preoperative stage; 147 ones underwent arterial switch surgery. Comparative analysis was carried out in 2 groups: “Astana+” group (born in Astana, n=74), “Astana–“ group (transported from outside, n=75). Along with demographic and perioperative data, we evaluated immediate outcomes (transportation-related mortality, in-hospital mortality).

RESULTS

Along with prenatally diagnosed patients (94.6% vs. 25.3%, p<0.001), patients with restrictive PFO at admission (43.2% vs. 21.3%, p=0.01) and arterial switch surgeries within the first week of life prevailed (46.6% vs. 16.2%, p<0.001) in the “Astana+” group. Transportation-related mortality was 0% and 1.3%, in-hospital mortality — 6.8% and 13.3%, respectively (p=0.2).

CONCLUSION

Birth of children with TGA near cardiac surgery center contributes to arterial switch surgery in the first week of life. Transportation of newborns with TGA in a country with a vast territory and low population density does not affect preoperative survival and in-hospital mortality. If long-distance transportation is necessary, restrictive PFO is a factor limiting transportability of newborns with TGA.