Document Detail


Factors affecting long-term risk of aortic arch recoarctation after the Norwood procedure.
MedLine Citation:
PMID:  18355534     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to identify factors predicting risk of aortic arch recoarctation after the Norwood procedure. METHODS: Patient records were reviewed retrospectively for consecutive patients who underwent the Norwood procedure from 1996 to 2005. Preoperative and intraoperative parameters were identified for analysis. Aortic arch recoarctation was defined by the need for catheter or surgical reintervention. Data were analyzed using survival analysis, with freedom from intervention as the outcome. Factors predicting need for reintervention were analyzed using Cox proportional hazards regression. RESULTS: Thirty-five recoarctations were observed in 117 patients (30%). Freedom from aortic arch reintervention at six months, one, three, and five years were 72%, 63%, 56%, and 52%, respectively. The majority of arch reinterventions occurred in the first six months (63%), involving either surgical (43%) or catheter (57%) techniques. The use of bovine pericardium showed the greatest risk for potential recoarctation (hazard ratio = 1.81 [0.90-3.64], p = 0.09). Age, gender, weight, ascending aortic diameter, ventricular morphology, primary anatomic diagnosis, and coarctation shelf resection were not found to be predictors of recoarctation. CONCLUSIONS: Most interventions for aortic arch recoarctation after the Norwood procedure occur within the first six months of life. The type of patch material used for arch reconstruction appears to influence, most strongly, the long-term risk of aortic arch recoarctation.
Authors:
Traci M Ashcraft; Karen Jones; William L Border; Pirooz Eghtesady; Jeffrey M Pearl; Phillip R Khoury; Peter B Manning
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-21     Completed Date:  2008-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1397-401; discussion 1401-2     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Surgery, The Heart Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
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MeSH Terms
Descriptor/Qualifier:
Aortic Coarctation / mortality,  radiography,  surgery*
Aortography
Cardiac Surgical Procedures / adverse effects*,  methods
Cohort Studies
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Predictive Value of Tests
Probability
Proportional Hazards Models
Recurrence
Reoperation / methods,  mortality
Retrospective Studies
Risk Assessment
Risk Factors
Survival Analysis
Time Factors
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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