Prediction of early pulmonary artery stenosis after arterial switch operation: the role of intraoperative transesophageal echocardiography.
Cardiology
; 109(4): 230-6, 2008.
Article
em En
| MEDLINE
| ID: mdl-17873486
ABSTRACT
OBJECTIVES:
To investigate prospectively the prediction of the neopulmonary stenosis (neo-PS) after arterial switch operation (ASO) for transposition of the great artery (TGA) with intraoperative transesophageal echocardiography (TEE).METHODS:
Infants with TGA undergoing the ASO were prospectively studied over 5 years. The neo-PS was defined when the peak flow velocity was over 3 m/s at the neo main pulmonary artery (neo-MPA) after ASO by TEE (TEEPS). Catheterization was performed if estimated peak neo-PS pressure gradient was over 40 mm Hg by transthoracic echocardiography. Balloon angioplasty was tried first and surgical reoperation was reserved for those with failed angioplasty.RESULTS:
In total 49 consecutive patients were enrolled into the cohort study. TEEPS was identified in 21 patients. For patients with TEEPS, freedom from reintervention was 28% at 1 year and 23% at 2 years. For patients without TEEPS, freedom from reintervention for PS was 92% at 1 year and 78% at 2 years. The time interval from ASO to reintervention was significantly shorter in patients with TEEPS than without TEEPS. Existence of TEEPS and non-Lecompte method were main risk factor for reintervention.CONCLUSION:
The present study demonstrated that the application of intraoperative TEE for infants undergoing ASO is very helpful in predicting the development of early postoperative neo-PS.
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Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Pulmonar
/
Transposição dos Grandes Vasos
/
Ecocardiografia Transesofagiana
/
Cuidados Intraoperatórios
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Cardiology
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Taiwan