Outcomes of Interrupted Aortic Arch Repair in Children With Biventricular Circulation.
Ann Thorac Surg
; 111(6): 2050-2058, 2021 06.
Article
in En
| MEDLINE
| ID: mdl-32721457
ABSTRACT
BACKGROUND:
To evaluate the outcomes after surgical repair of interrupted aortic arch in patients with biventricular circulation.METHODS:
We reviewed all children from a single institution (N = 177) who had interrupted aortic arch repair between 1978 and 2018. Patients were separated into simple (n = 122) and complex (n = 55) group based on their concomitant anomalies.RESULTS:
Median age at repair was 6 days (range, 1-298 days) and median weight was 3.1 kg (range, 0.95-5.1 kg). Median follow-up time was 11.5 years (mean 12.6 years; range, 0.1-35.9 years). Overall early mortality was 11.9% (21 of 177) and there were 5 late deaths. Era of surgery did not impact on overall survival (P = .37). Between 2000 and 2018, there was a significant difference in early mortality between the simple and complex group (3.2% [2 of 62] vs 24.1% [7 of 29], P = .002). There was an improvement in mortality in the simple group over time (P = .03). Competing risks analysis showed at 15 years after the initial operation 14% had died without arch reoperation, 15.2% had undergone aortic arch reoperation, and 70.8% were alive without arch reoperation. Reoperation on the aortic arch was more common in the complex group compared to the simple group (20.0% [11 of 55] vs 9.0% [11 of 122], P< .001).CONCLUSIONS:
Survival of patients with interrupted aortic arch and associated simple anomalies has improved over time, although mortality in patients with complex congenital cardiac lesions remains high.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aorta, Thoracic
/
Heart Defects, Congenital
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
Ann Thorac Surg
Year:
2021
Type:
Article
Affiliation country:
Australia