Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in Sudan
Transposition of great arteries (TGA) is a critical congenital heart disease leading to a fatal outcome if timely management is not provided. Management in low-income countries is challenging. A retrospective analysis was carried out at Sudan Heart Center for infants with TGA who underwent balloon a...
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Ubiquity Press
2025-01-01
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Online Access: | https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1387 |
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author | Sulafa K. M. Ali Amna Elsheikh Mohammed Abdulrahman Alhassan |
author_facet | Sulafa K. M. Ali Amna Elsheikh Mohammed Abdulrahman Alhassan |
author_sort | Sulafa K. M. Ali |
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description | Transposition of great arteries (TGA) is a critical congenital heart disease leading to a fatal outcome if timely management is not provided. Management in low-income countries is challenging. A retrospective analysis was carried out at Sudan Heart Center for infants with TGA who underwent balloon atrial septostomy (BAS) from January 2010 to December 2020. Immediate clinical- and procedure-related outcomes were evaluated. Intermediate-term outcomes were studied using follow-up hospital records as well as direct telephone calls. The study included 75 infants (70% males) with a median age at presentation of 25 and at the time of BAS of 28 days. Pre-BAS median oxygen saturation was 48 (Interquartile Range (IQR) 40–60%). BAS was performed under fluoroscopy and echocardiography guidance with immediate success achieved in 98% of patients. Post-BAS oxygen saturation increased to 87 (IQR 85–90%) with a median improvement of 40% (p = 0.048), which was more significant in those less than 2 weeks of age. Minor complications occurred in 14 patients, and two patients (2.6%) died. Surgery (atrial in 44% and arterial switch operations in 41%) was performed in 39 patients (52%) at a mean age of three months with perioperative mortality of 30%. Infants who underwent surgery had a significantly higher survival rate (69%) compared to those who did not (5.6%) (p < 0.001). Patients with TGA present at a late age with good immediate outcomes of BAS. Access to surgery is limited with a high surgical mortality. Those who survived surgery had good intermediate-term outcomes while most unoperated patients died. |
format | Article |
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institution | Kabale University |
issn | 2211-8179 |
language | English |
publishDate | 2025-01-01 |
publisher | Ubiquity Press |
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spelling | doaj-art-dc710e4dbffd4bc6a97bf6457691ece32025-02-11T05:32:44ZengUbiquity PressGlobal Heart2211-81792025-01-012015510.5334/gh.13871368Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in SudanSulafa K. M. Ali0https://orcid.org/0000-0001-9436-1680Amna Elsheikh1https://orcid.org/0009-0008-5321-4009Mohammed Abdulrahman Alhassan2https://orcid.org/0000-0002-1282-3683Consultant Pediatric Cardiologist, Sudan Heart Center, University of KhartoumPediatric Specialist, Al Buluk Hospital, OmdurmanPrince Sattam Bin Abdulaziz University, Al KharjTransposition of great arteries (TGA) is a critical congenital heart disease leading to a fatal outcome if timely management is not provided. Management in low-income countries is challenging. A retrospective analysis was carried out at Sudan Heart Center for infants with TGA who underwent balloon atrial septostomy (BAS) from January 2010 to December 2020. Immediate clinical- and procedure-related outcomes were evaluated. Intermediate-term outcomes were studied using follow-up hospital records as well as direct telephone calls. The study included 75 infants (70% males) with a median age at presentation of 25 and at the time of BAS of 28 days. Pre-BAS median oxygen saturation was 48 (Interquartile Range (IQR) 40–60%). BAS was performed under fluoroscopy and echocardiography guidance with immediate success achieved in 98% of patients. Post-BAS oxygen saturation increased to 87 (IQR 85–90%) with a median improvement of 40% (p = 0.048), which was more significant in those less than 2 weeks of age. Minor complications occurred in 14 patients, and two patients (2.6%) died. Surgery (atrial in 44% and arterial switch operations in 41%) was performed in 39 patients (52%) at a mean age of three months with perioperative mortality of 30%. Infants who underwent surgery had a significantly higher survival rate (69%) compared to those who did not (5.6%) (p < 0.001). Patients with TGA present at a late age with good immediate outcomes of BAS. Access to surgery is limited with a high surgical mortality. Those who survived surgery had good intermediate-term outcomes while most unoperated patients died.https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1387transposition of great arteriesballoon septostomyoutcomessudan |
spellingShingle | Sulafa K. M. Ali Amna Elsheikh Mohammed Abdulrahman Alhassan Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in Sudan Global Heart transposition of great arteries balloon septostomy outcomes sudan |
title | Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in Sudan |
title_full | Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in Sudan |
title_fullStr | Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in Sudan |
title_full_unstemmed | Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in Sudan |
title_short | Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in Sudan |
title_sort | immediate and intermediate term outcomes of infants with transposition of great arteries who underwent balloon atrial septostomy in sudan |
topic | transposition of great arteries balloon septostomy outcomes sudan |
url | https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1387 |
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