Pediatric

ASO (Arterial Switch Operation)

Description

ASO (Arterial Switch Operation) is a surgical procedure to restore the two major arteries, which are attached to the wrong ventricles of the heart. This is a rare disease often find in newborns where the blood having oxygen is pumped back into the lungs while the blood lacking the oxygen is propelled all over the body. This can lead to several health issues and must be dealt with at once. The treatment requires an open heart surgery, which must be performed within the first few weeks of the birth where the baby’s heart is stopped temporarily while the blood flow is done through a heart-lung machine. Any other issues related to the heart and arteries are handled in between.

In this procedure, the main artery coronary, which is responsible for supplying the blood into the heart is dislocated from its actual position of the aorta and relocated into the new aorta carrying the oxygenated blood throughout the body.

Treatment of Arterial Switch Operation (ASO)

The surgical treatment requires the patient to undergo cardiopulmonary bypass or predominantly low-flow hypothermic cardiopulmonary bypass. The two major arteries are inspected to find out defects and the coronary arteries are transferred to the neo-aorta. Afterwards, the right atrium is opened and atrial septal defect or any other defects are fixed. The patient is then treated with customized ultrafiltration after establishing a continuity between the right ventricle and pulmonary arteries. After the whole procedure, a plastic strut is consigned between the sternal halves and the skin is closed for good.

Post Operative Complications

  • Coronary artery dysfunction after ASO can cause death, which can be diagnosed through ST elevation, low cardiac output and high cardiac enzymes
  • Ischemia: Overflow of blood to an organ or any other part of the body, especially heart
  • Impaired LV function which can be diagnosed through ECHO, low cardiac output and high LA pressure
  • Bleeding
  • Infection
  • Lung injuries, including respiratory failure, reperfusion injury and sepsis
  • Septic shock, coma, pacing, arrhythmia and feeding intolerance
  • NEC, I.O. and UTI
  • Blood clots
  • Air bubbles
  • Heart Attack
  • Heart related issues
  • Pneumonia
  • Stroke

Post operative Care

There are some guidelines given to parents and guardians of the child after Arteries Switch Operation such as how to give the child prescriptions, what activities are okay for the child and how to handle the openings.

The child needs to be rested for several weeks at home after the operation for recovery. Consult with your physician about how early your child can return to school and indulge in some decent outdoor activities.

Regular health checkups must be done every 6-12 months with a cardiologist. Your child may also require antibiotics before visiting a dentist to prevent hazardous heart diseases.