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Pediatr Cardiol ; 40(2): 366-373, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30413855

RESUMO

INTRODUCTION: Post-operative length of stay (LOS) after the arterial switch operation (ASO) is variable. The association between pre-operative non-invasive measures of ventricular function and post-operative course has not been well established. The aims of this study were to (1) evaluate the relationship between pre-operative non-invasive measures of ventricular function and post-operative LOS and (2) evaluate the change in ventricular function after ASO. METHODS: Data were reviewed in consecutive ASO patients between 2010 and 2016. The primary outcome was post-operative LOS. Echocardiograms obtained during the pre-operative period and at the time of discharge were retrospectively analyzed using speckle-tracking echocardiography. Pearson's correlation between patient-specific, pre-operative, and echocardiographic data versus post-operative LOS was assessed. RESULTS: Fifty-two patients were included in analyses, 39 neonates and 13 infants. Left ventricular (LV) longitudinal strain correlated with post-operative LOS for infants age > 28 days (r = 0.62, p = 0.03), but not for neonates (r = 0.14, p = 0.40). Operative age (r = - 0.42, p = 0.003), weight at surgery (r = - 0.48, p ≤ 0.001), and cardiopulmonary bypass time (r = 0.30, p = 0.045) also correlated with post-operative LOS. Standard 2D measures of ventricular function did not correlate with post-operative LOS. LV ejection fraction and longitudinal strain worsened post-operatively. CONCLUSION: Higher pre-operative LV longitudinal strain (representing worse LV function) is associated with increased post-operative LOS after ASO in infants > 28 days, but not in neonates. LV ejection fraction and longitudinal strain worsened after ASO. Future studies should assess the utility of performing STE in risk stratifying patients prior to ASO.


Assuntos
Transposição das Grandes Artérias/métodos , Ventrículos do Coração/fisiopatologia , Tempo de Internação/estatística & dados numéricos , Transposição dos Grandes Vasos/cirurgia , Função Ventricular Esquerda/fisiologia , Fatores Etários , Transposição das Grandes Artérias/efeitos adversos , Estudos de Coortes , Ecocardiografia/métodos , Feminino , Ventrículos do Coração/diagnóstico por imagem , Humanos , Lactente , Recém-Nascido , Masculino , Período Pós-Operatório , Cuidados Pré-Operatórios/métodos , Estudos Retrospectivos , Transposição dos Grandes Vasos/fisiopatologia
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