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Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study
VL. Vida, L. Zanotto, L. Zanotto, G. Stellin, . , M. Padalino, G. Sarris, E. Protopapas, C. Prospero, C. Pizarro, E. Woodford, T. Tlaskal, H. Berggren, M. Kostolny, I. Omeje, B. Asfour, A. Kadner, T. Carrel, PH. Schoof, M. Nosal, J. Fragata, M....
Language English Country Netherlands
Document type Journal Article, Multicenter Study
- MeSH
- Aortic Valve Insufficiency epidemiology etiology surgery MeSH
- Child MeSH
- Double Outlet Right Ventricle surgery MeSH
- Incidence MeSH
- Infant MeSH
- Arterial Switch Operation adverse effects MeSH
- Humans MeSH
- Survival Rate trends MeSH
- Adolescent MeSH
- Follow-Up Studies MeSH
- Postoperative Complications epidemiology etiology surgery MeSH
- Child, Preschool MeSH
- Prognosis MeSH
- Reoperation methods MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Transposition of Great Vessels surgery MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe epidemiology MeSH
BACKGROUND: We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type. METHODS: Seventeen centers belonging to the European Congenital Heart Surgeons Association (ECHSA) contributed to data collection. We included 111 patients who underwent LSRs after 7,951 ASOs (1.4%) between January 1975 and December 2010. Original diagnoses included D-TGA (n = 99) and DORV TGA-type (n = 12). Main indications for LSR were neoaortic valve insufficiency (n = 52 [47%]) and coronary artery problems (CAPs) (n = 21 [19%]). RESULTS: Median age at reoperation was 8.2 years (interquartile range [IQR], 2.9-14 years). Seven patients died early after LSRs (6.3%); 4 patients with D-TGA (5.9%) and 3 patients with DORV TGA-type (25%) (p = 0.02). Median age at last follow-up was 16.1 years (IQR, 9.9-21.8 years). Seventeen patients (16%) required another reoperation, which was more frequent in patients with DORV- TGA type (4 of 9 [45%]) than in patients with D-TGA (13 of 95 [14%]). Late death occurred in 4 patients (4 of 104 [3.8%]). The majority of survivors were asymptomatic at last clinical examination (84 of 100 [84%]). CONCLUSIONS: Reoperations for residual LSRs are infrequent but may become necessary late after an ASO, predominantly for neoaortic valve insufficiency and CAPs. Risk at reoperation is not negligible, and DORV TGA-type anatomy, as well as procedures on the coronary arteries, were significantly associated with a higher morbidity and a lower overall survival. Recurrent reoperations after LSRs may be required.
Children's Heart Centre University Hospital Motol Prague Czech Republic
Children's Memorial Health Institute Varsavia Poland
Childrens Heart Centre Slovak Republic Bratislava Slovakia
Department for Cardiovascular Surgery University of Bern Bern Switzerland
Department of Cardiothoracic Surgery Hospital de Santa Marta and Nova Medical School Lisbon Portugal
Department of Cardiothoracic Surgery Leiden University Medical Center Leiden Netherlands
Department of Statistical Sciences University of Padua Padua Italy
Division of Cardiac Surgery Johns Hopkins University Baltimore USA
Divison of cardiovascular Surgery Geneva University Hospitals Geneva Switzerland
Great Ormond Street Hospital Cardiothoracic Unit London UK
Herma Heart Center Medical College of Wisconsin Milwaukee WI USA
Herma Heart Center Medical College of Wisconsin Wisconsin USA
Nemours Cardiac Center Alfred 1 duPont Hospital for Children Wilmington Delaware USA
References provided by Crossref.org
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- $a Vida, Vladimiro L $u Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy.
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- $a Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study / $c VL. Vida, L. Zanotto, L. Zanotto, G. Stellin, . , M. Padalino, G. Sarris, E. Protopapas, C. Prospero, C. Pizarro, E. Woodford, T. Tlaskal, H. Berggren, M. Kostolny, I. Omeje, B. Asfour, A. Kadner, T. Carrel, PH. Schoof, M. Nosal, J. Fragata, M. Kozłowski, B. Maruszewski, LA. Vricella, DE. Cameron, V. Sojak, M. Hazekamp, J. Salminen, IP. Mattila, J. Cleuziou, PO. Myers, V. Hraska,
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- $a BACKGROUND: We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type. METHODS: Seventeen centers belonging to the European Congenital Heart Surgeons Association (ECHSA) contributed to data collection. We included 111 patients who underwent LSRs after 7,951 ASOs (1.4%) between January 1975 and December 2010. Original diagnoses included D-TGA (n = 99) and DORV TGA-type (n = 12). Main indications for LSR were neoaortic valve insufficiency (n = 52 [47%]) and coronary artery problems (CAPs) (n = 21 [19%]). RESULTS: Median age at reoperation was 8.2 years (interquartile range [IQR], 2.9-14 years). Seven patients died early after LSRs (6.3%); 4 patients with D-TGA (5.9%) and 3 patients with DORV TGA-type (25%) (p = 0.02). Median age at last follow-up was 16.1 years (IQR, 9.9-21.8 years). Seventeen patients (16%) required another reoperation, which was more frequent in patients with DORV- TGA type (4 of 9 [45%]) than in patients with D-TGA (13 of 95 [14%]). Late death occurred in 4 patients (4 of 104 [3.8%]). The majority of survivors were asymptomatic at last clinical examination (84 of 100 [84%]). CONCLUSIONS: Reoperations for residual LSRs are infrequent but may become necessary late after an ASO, predominantly for neoaortic valve insufficiency and CAPs. Risk at reoperation is not negligible, and DORV TGA-type anatomy, as well as procedures on the coronary arteries, were significantly associated with a higher morbidity and a lower overall survival. Recurrent reoperations after LSRs may be required.
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