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Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study

2017-09Journal article Open access
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dc.contributor.authorVida, V
dc.contributor.authorZanotto, L
dc.contributor.authorZanotto, L
dc.contributor.authorStellin, G
dc.contributor.authorPadalino, M
dc.contributor.authorSarris, G
dc.contributor.authorProtopapas, E
dc.contributor.authorProspero, C
dc.contributor.authorPizarro, C
dc.contributor.authorWoodford, E
dc.contributor.authorTlaskal, T
dc.contributor.authorBerggren, H
dc.contributor.authorKostolny, M
dc.contributor.authorOmeje, I
dc.contributor.authorAsfour, B
dc.contributor.authorKadner, A
dc.contributor.authorCarrel, T
dc.contributor.authorSchoof, PH
dc.contributor.authorNosal, M
dc.contributor.authorFragata, J
dc.contributor.authorKozłowski, M
dc.contributor.authorMaruszewski, B
dc.contributor.authorVricella, L
dc.contributor.authorCameron, D
dc.contributor.authorSojak, V
dc.contributor.authorHazekamp, M
dc.contributor.authorSalminen, J
dc.contributor.authorMattila, I
dc.contributor.authorCleuziou, J
dc.contributor.authorMyers, P
dc.contributor.authorHraska, V
dc.date.accessioned2017-10-13T11:17:06Z
dc.date.available2017-10-13T11:17:06Z
dc.date.issued2017-09
dc.description.abstractBACKGROUND: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Thorac Surg. 2017 Sep;104(3):899-906pt_PT
dc.identifier.doi10.1016/j.athoracsur.2017.04.026pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2759
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAdolescentpt_PT
dc.subjectAortic Valve Insufficiencypt_PT
dc.subjectArterial Switch Operationpt_PT
dc.subjectChildpt_PT
dc.subjectChild, Preschoolpt_PT
dc.subjectDouble Outlet Right Ventriclept_PT
dc.subjectEuropept_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHumanspt_PT
dc.subjectIncidencept_PT
dc.subjectInfantpt_PT
dc.subjectMalept_PT
dc.subjectPostoperative Complicationspt_PT
dc.subjectPrognosispt_PT
dc.subjectReoperationpt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSurvival Ratept_PT
dc.subjectTransposition of Great Vesselspt_PT
dc.subjectHSM CCTpt_PT
dc.titleLeft-Sided Reoperations After Arterial Switch Operation: A European Multicenter Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage906pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage899pt_PT
oaire.citation.titleAnnals of Thoracic Surgerypt_PT
oaire.citation.volume104pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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