Prematurity is a risk factor for adverse outcomes after arterial switch operation in newborns with d-TGA (d-TGA). In this study, we sought to investigate the impact of prematurity on postnatal and perioperative clinical management, morbidity, and mortality during hospitalization in neonates with simple and complex d-TGA who received arterial switch operation (ASO). Monocentric retrospective analysis of 100 newborns with d-TGA. Thirteen infants (13.0%) were born premature. Preterm infants required significantly more frequent mechanical ventilation in the delivery room (69.2% vs. 34.5%, p = 0.030) and during the preoperative course (76.9% vs. 37.9%, p = 0.014). Need for inotropic support (30.8% vs. 8.0%, p = 0.035) and red blood cell transfusions (46.2% vs. 10.3%, p = 0.004) was likewise increased. Preoperative mortality (23.1% vs 0.0%, p = 0.002) was significantly increased in preterm infants, with necrotizing enterocolitis as cause of death in two of three infants. In contrast, mortality during and after surgery did not differ significantly between the two groups. Cardiopulmonary bypass times were similar in both groups (median 275 vs. 263 min, p = 0.322). After ASO, arterial lactate (34.5 vs. 21.5 mg/dL, p = 0.007), duration of mechanical ventilation (median 175 vs. 106 h, p = 0.038), and venous thrombosis (40.0% vs. 4.7%, p = 0.004) were increased in preterm, as compared to term infants. Gestational age (adjusted unit odds ratio 0.383, 95% confidence interval 0.179–0.821, p = 0.014) was independently associated with mortality. Prematurity is associated with increased perioperative morbidity and increased preoperative mortality in d-TGA patients.

早产是d -TGA ( d -TGA) 新生儿动脉转换手术后不良结局的危险因素。在这项研究中，我们试图调查早产对接受动脉转换手术 (ASO)的简单和复杂d -TGA 新生儿住院期间的产后和围手术期临床管理、发病率和死亡率的影响。100 例d -TGA新生儿单中心回顾性分析。13 名婴儿 (13.0%) 早产。早产儿在产房（69.2% 对 34.5%，p  = 0.030）和术前过程（76.9% 对 37.9%，p = 0.014)。对正性肌力支持（30.8% 对 8.0%，p  = 0.035）和红细胞输血（46.2% 对 10.3%，p  = 0.004）的需求同样增加。早产儿的术前死亡率（23.1% vs 0.0%，p  = 0.002）显着增加，三名婴儿中有两名死于坏死性小肠结肠炎。相比之下，两组手术期间和手术后的死亡率没有显着差异。两组的体外循环时间相似（中位数 275 对 263 分钟，p  = 0.322）。ASO 后，动脉乳酸（34.5 vs. 21.5 mg/dL，p  = 0.007）、机械通气持续时间（中位数 175 vs. 106 小时，p  = 0.038）和静脉血栓形成（40.0% vs. 4.7%，p  = 0.004）与足月婴儿相比，早产儿增加。胎龄（调整后的单位优势比 0.383，95% 置信区间 0.179-0.821，p  = 0.014）与死亡率独立相关。早产与d -TGA 患者围手术期发病率增加和术前死亡率增加有关。