Early Mortality
There were three early deaths (27.3%) among the 11 patients. The first patient was patient 2, a 4-month-old female infant weighing 3.5 kg with TGA, type A IAA. The relationship between the great arteries was anteroposterior, with a remarkable discrepancy of 4:1. The patient had both perimembranous and muscular VSDs and normal coronary artery anatomy (1L, Cx; 2R), and underwent an uneventful surgery. However, an immediate postoperative echocardiogram demonstrated a low left ventricular ejection fraction of approximately 25%, without explicit segmental wall motion abnormality. Severe pneumonia followed, and a high-frequency oscillatory ventilator was used. The patient died of sepsis on postoperative day (POD) 34.
The second was patient 3, a 10-day-old and 2.1 kg premature newborn girl with TBA, type A IAA, side by side relationship of the great vessels with significant mismatch 3:1, and a single coronary artery ostium at sinus 1. The patient’s surgical procedure was uneventful. Moderate aortic valve regurgitation was detected by echocardiography on POD three but did not evolve thereafter. The patient’s chest was left open after surgery and was not successfully closed until POD 13 because of refractory oliguria and severe edema. The patient died of severe capillary leakage on POD 17.
The third patient was patient 8, a 2-month-old and 6.1 kg boy with TBA, type A IAA, anteroposterior great vessels, and typical coronary artery anatomy. The patient exhibited anuria one day after surgery and subsequently immediate renal failure. Soon after, multiple organ dysfunction developed. After conferring with his parents, therapy was stopped 26 days after the surgery; eventually, the infant died.