title: Impact of prenatal diagnosis of transposition of the great arteries on postnatal outcome.
abstract: OBJECTIVE
  To assess the impact of prenatal diagnosis of transposition of the great arteries (TGA) on postnatal outcome.
  
  
  METHODS
  Hundred and fifty-four patients with either simple (n = 101) or complex forms (n = 53) of TGA, diagnosed prenatally (G1, n = 88) or postnatally (G2, n = 66), who were admitted and underwent surgical correction in our centre between 1998 and 2014, were analysed.
  
  
  RESULTS
  Prostaglandin E1(PgE1) infusion and balloon atrial septostomy (BAS) were performed in the first 48 h after birth more commonly in G1. The hospital mortality rate for the whole group was 7.1%, higher for complex forms (13.2%) than for simple TGA (3.9%), (p = 0.034). The overall mortality rate was similar in G1 and G2. The mortality for simple TGA was higher when PgE1infusion and BAS were implemented after the first 48 h (p = 0.001). All deaths in G2 occurred in patients first receiving PgE1and BAS beyond 48 h. PgE1was initiated in the first 48 h in most patients (83%) with simple TGA postnatally diagnosed.
  
  
  CONCLUSIONS
  Adequate measures in the first 48 h after birth are essential to reduce the early mortality in TGA, especially in the simple form. This can be provided by prenatal diagnosis or by early neonatal clinical suspicion and prompt measures.
authors.affiliation: a Department of Pediatrics, Pediatric Heart Institute , Hospital Universitario 12 de Octubre , Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Domínguez-Manzano
authors.affiliation: b Department of Obstetrics and Gynaecology, Fetal Medicine Unit , Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid , Spain.
authors.forename: I
authors.initials: I
authors.lastname: Herraiz
authors.affiliation: a Department of Pediatrics, Pediatric Heart Institute , Hospital Universitario 12 de Octubre , Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Mendoza
authors.affiliation: a Department of Pediatrics, Pediatric Heart Institute , Hospital Universitario 12 de Octubre , Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Aguilar
authors.affiliation: b Department of Obstetrics and Gynaecology, Fetal Medicine Unit , Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid , Spain.
authors.forename: D
authors.initials: D
authors.lastname: Escribano
authors.affiliation: a Department of Pediatrics, Pediatric Heart Institute , Hospital Universitario 12 de Octubre , Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Toral
authors.affiliation: b Department of Obstetrics and Gynaecology, Fetal Medicine Unit , Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid , Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gómez-Montes
authors.affiliation: b Department of Obstetrics and Gynaecology, Fetal Medicine Unit , Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid , Spain.
authors.forename: A
authors.initials: A
authors.lastname: Galindo
mesh_terms: D006348:Cardiac Surgical Procedures / Q000401:mortality; D004452:Echocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery
keywords: Transposition of the great arteries; arterial switch operation; outcome; prenatal diagnosis; prostaglandin E1