Excellent Survival With a Focus on Pulmonary Artery Reinterventions After the Arterial Switch Operation.
World J Pediatr Congenit Heart Surg
; 15(4): 421-429, 2024 Jul.
Article
en En
| MEDLINE
| ID: mdl-38751363
ABSTRACT
Background:
We sought to evaluate the outcomes in patients who underwent the arterial switch operation (ASO) over a 20-year period at a single institution.Methods:
The current study is a retrospective review of 180 consecutive patients who underwent the ASO for biventricular surgical correction of dextro-transposition of the great arteries (d-TGA) between 2002 and 2022.Results:
Among 180 patients, 121 had TGA-intact ventricular septum, 47 had TGA-ventricular septal defect and 12 had Taussig-Bing Anomaly (TBA). The median follow-up time was 6.7 years (interquartile range 3.9-8.7 years). There were five early (2.8%) and one late (0.6%) mortality. Survival was 96.6% at one year and beyond. Reoperations were performed in 31 patients (17%). Taussig Bing Anomaly was found to increase the risk of reoperation by 17 times (P < .0001). A total of 37 (21%) patients underwent 53 reinterventions (14 surgical procedures, 39 catheter interventions) specifically addressing pulmonary artery (PA) stenosis. Freedom from PA reintervention was 97%, 87%, 70%, and 55% at 1, 5, 10, and 15 years, respectively. By bivariable analysis, TBA (P = .003, odds ratio [OR] 6.4, 95% confidence interval [CI] 1.9-21.7), mild PA stenosis at discharge (P ≤ .001, OR 6.1, 95% CI 2.7-13.6), and moderate or severe PA stenosis at discharge (P ≤ .001, OR 12.7, 95% CI 5-32.2) were identified as predictors of reintervention on PA. In the last follow-up of 174 survivors, 24 patients (14%) had moderate or greater PA stenosis, two (1%) had moderate neoaortic valve regurgitation, and 168 were New York Heart Association status I.Conclusions:
Our results demonstrated excellent survival and functional status following the ASO for d-TGA; however, patients remain subject to frequent reinterventions especially on the pulmonary arteries.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Arteria Pulmonar
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Reoperación
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Transposición de los Grandes Vasos
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Operación de Switch Arterial
Límite:
Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Revista:
World J Pediatr Congenit Heart Surg
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos