Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/2759
Título: Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study
Autor: Vida, V
Zanotto, L
Zanotto, L
Stellin, G
Padalino, M
Sarris, G
Protopapas, E
Prospero, C
Pizarro, C
Woodford, E
Tlaskal, T
Berggren, H
Kostolny, M
Omeje, I
Asfour, B
Kadner, A
Carrel, T
Schoof, PH
Nosal, M
Fragata, J
Kozłowski, M
Maruszewski, B
Vricella, L
Cameron, D
Sojak, V
Hazekamp, M
Salminen, J
Mattila, I
Cleuziou, J
Myers, P
Hraska, V
Palavras-chave: Adolescent
Aortic Valve Insufficiency
Arterial Switch Operation
Child, Preschool
Double Outlet Right Ventricle
Follow-Up Studies
Postoperative Complications
Retrospective Studies
Risk Factors
Survival Rate
Transposition of Great Vessels
Data: Set-2017
Editora: Elsevier
Citação: Ann Thorac Surg. 2017 Sep;104(3):899-906
Resumo: 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.
Peer review: yes
URI: http://hdl.handle.net/10400.17/2759
DOI: 10.1016/j.athoracsur.2017.04.026
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