• Marco Modestini, Dario Massari, Susanne Huisman, StruysMichel M R FMMRFDepartment of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., RoofthooftMarcus T RMTRDepartment of Pediatric Cardiology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., and Jaap Jan Vos.
• Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: m.modestini@umcg.nl.
• J. Cardiothorac. Vasc. Anesth. 2024 Sep 26.

ObjectivesThis study aimed to assess the impact of persistent pulmonary hypertension of the newborn (PPHN) on perioperative morbidity and mortality in patients with dextro-transposition of the great arteries. Secondarily, we evaluated the association between postoperative outcomes and intraoperative variables including the duration of cardiopulmonary bypass, cerebral oxygen desaturation, and hypotension.DesignRetrospective observational study.SettingBeatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands, over a 14-year period from January 2005 to December 2018.ParticipantsThe study included 99 consecutive patients with simple dextro-transposition of the great arteries with or without a ventricular septal defect.InterventionsAll patients received preoperative management including intravenous prostaglandin E1 and, when necessary, a balloon atrial septostomy. Patients were then scheduled for an arterial switch operation.Measurements And Main ResultsPatients were divided into a PPHN and a non-PPHN group. The outcomes assessed included mortality (overall, preoperative, 30-day postoperative and late mortality) and postoperative morbidity (length of ventilatory support, intensive care unit and hospital stay, delayed sternal closure and resternotomy). PPHN was present in 31% of patients. Overall mortality was 8.1%, with no difference between PPHN and non-PPHN patients (9.7 v 7.4%, p = 0.70). PPHN had no effect on morbidity outcomes. A lower weight at birth was associated with preoperative mortality. Duration of cardiopulmonary bypass and intraoperative hypotension were associated with longer intensive care unit stay. Intraoperative hypotension and cerebral oxygen desaturation had no significant impact on mortality.ConclusionsPPHN did not significantly affect perioperative morbidity and mortality in d-TGA patients, suggesting a more favorable prognosis than previously reported.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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