| Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. | |
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MedLine Citation:
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PMID: 12427654 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Prior studies of coronary pattern and outcome after arterial switch operation (ASO) for transposition of the great arteries (TGA) have been hindered by limited statistical power. This meta-analysis assesses the effect of coronary anatomy on post-ASO mortality, both overall and adjusted for time. METHODS AND RESULTS: A literature search revealed 9 independent series that reported post-ASO mortality by coronary pattern in a total of 1942 patients. Odds ratios comparing all-cause mortality in patients with usual versus variant coronary patterns were calculated and combined by use of an empirical Bayesian model. Single coronary patterns, both of which loop around the great vessels, were associated with significant mortality (OR 2.9, 95% CI 1.3 to 6.8), whereas looping patterns that arose from 2 separate ostia were not (OR 1.2, 95% CI 0.8 to 1.9). This latter group includes patients with the most common variant, circumflex from right coronary artery. Patients with an intramural coronary artery had the greatest mortality (OR 6.5, 95% CI 2.9 to 14.2). Overall, patients with any variant coronary pattern had nearly twice the mortality seen in those with the usual pattern (OR 1.7, 95% CI 1.3 to 2.4). Single ostium patterns and intramural coronary arteries remained associated with significant added mortality after adjustment for time-trend effects. CONCLUSIONS: Over the past 2 decades, patients with common coronary variants have undergone ASO without added mortality compared with those with the usual coronary pattern. Those with intramural or single coronary arteries have significant added mortality that has persisted over time. |
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Authors:
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Sara K Pasquali; Vic Hasselblad; Jennifer S Li; David F Kong; Stephen P Sanders |
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Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis |
Journal Detail:
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Title: Circulation Volume: 106 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2002 Nov |
Date Detail:
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Created Date: 2002-11-12 Completed Date: 2002-11-25 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 2575-80 Citation Subset: AIM; IM |
Affiliation:
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Pediatric Cardiovascular Program, Duke University Medical Center, Durham, NC 27710, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Vessel Anomalies
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complications* Humans Infant, Newborn Odds Ratio Time Factors Transposition of Great Vessels / mortality, surgery* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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