ArticlePediatric cardiology2026
Timing of Arterial Switch Operation in Dextro-Transposition of Great Arteries with Intact Septum: Factors Associated with Delay, Practice Variation, and Associated Outcomes.
Article in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Outcomes of Congenital Heart Disease Deliveries at a Freestanding Children's Hospital.Pediatric cardiology · 2026Article
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9 authors.
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Abstract
We examined the current practice, factors associated with delay, and impact of timing of arterial switch operation (ASO) on outcomes of d-transposition of great arteries (d-TGA) with intact ventricular septum (IVS). Neonates with d-TGA + IVS undergoing ASO were identified from the Pediatric Health Informational System database. Factors associated with delayed repair, practice trends, and outcomes related to surgical timing were analyzed. A cut-point analysis was performed to determine if an age threshold predicted in-hospital death or post-op ECMO. A total of 3523 patients were included. The distribution by age was: 0-3 d: 24%, 4-7 d: 51%, 8-14 d: 20%, 15-30 d: 6%; median: 5 d(IQR 4-8). A cut-off age of 7 days was identified for the composite outcome (death/ECMO), with an odds ratio of 1.79 (95%CI: 1.13-2.82), p = 0.013, after adjusting for prematurity and other confounders. Predictors of delay beyond seven days included [OR(95% CI)] non-birth admissions:6.31(4.37-9.12), < 2 kg-birthweight: 3.21(1.69-6.09), pre-operative-stroke: 2.86(1.73-4.74), and balloon atrial septostomy: 2.25(1.81-2.79). Increasing center case volume was associated with earlier repair: 0.82(0.78-0.85), all p < 0.05. A trend was observed in decreasing age at ASO in the latest study years: 2018-2024 median age (IQR): 5 days (3-7) vs 2004-2017: 6 days (4-8), p < 0.001. In this large multicenter cohort comprised exclusively of d-TGA + IVS neonates; we found that ASO performed after the age of seven days resulted in worse in-hospital outcomes. Factors associated with surgical delay included non-birth admission, low-birthweight, pre-operative stroke, and balloon atrial septostomy. A trend toward very early repair within the first five days of life has emerged in the past decade.
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