Document Detail


The arterial switch operation in Europe for transposition of the great arteries: a multi-institutional study from the European Congenital Heart Surgeons Association.
MedLine Citation:
PMID:  16935120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study analyzes the results of the arterial switch operation for transposition of the great arteries in member institutions of the European Congenital Heart Surgeons Association. METHODS: The records of 613 patients who underwent primary arterial switch operations in each of 19 participating institutions in the period from January 1998 through December 2000 were reviewed retrospectively. RESULTS: A ventricular septal defect was present in 186 (30%) patients. Coronary anatomy was type A in 69% of the patients, and aortic arch pathology was present in 20% of patients with ventricular septal defect. Rashkind septostomy was performed in 75% of the patients, and 69% received prostaglandin. There were 37 hospital deaths (operative mortality, 6%), 13 (3%) for patients with an intact ventricular septum and 24 (13%) for those with a ventricular septal defect (P < .001). In 36% delayed sternal closure was performed, 8% required peritoneal dialysis, and 2% required mechanical circulatory support. Median ventilation time was 58 hours, and intensive care and hospital stay were 6 and 14 days, respectively. Although of various preoperative risk factors the presence of a ventricular septal defect, arch pathology, and coronary anomalies were univariate predictors of operative mortality, only the presence of a ventricular septal defect approached statistical significance (P = .06) on multivariable analysis. Of various operative parameters, aortic crossclamp time and delayed sternal closure were also univariate predictors; however, only the latter was an independent statistically significant predictor of death. CONCLUSIONS: Results of the procedure in European centers are compatible with those in the literature. The presence of a ventricular septal defect is the clinically most important preoperative risk factor for operative death, approaching statistical significance on multivariable analysis.
Authors:
George E Sarris; Andrew C Chatzis; Nicolas M Giannopoulos; George Kirvassilis; Hakan Berggren; Mark Hazekamp; Thierry Carrel; Juan V Comas; Duccio Di Carlo; Willem Daenen; Tjark Ebels; Josè Fragata; Victor Hraska; Vladimir Ilyin; Harald L Lindberg; Dominique Metras; Marco Pozzi; Jean Rubay; Heikki Sairanen; Giovanni Stellin; Andreas Urban; Carin Van Doorn; Gerhard Ziemer;
Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2006-08-02
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  132     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-28     Completed Date:  2006-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633-9     Citation Subset:  AIM; IM    
Affiliation:
Onassis Cardiac Surgery Center, Athens, Greece. gsarris@hol.gr
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MeSH Terms
Descriptor/Qualifier:
Europe
Female
Humans
Infant
Infant, Newborn
Male
Multivariate Analysis
Retrospective Studies
Transposition of Great Vessels / surgery*
Vascular Surgical Procedures / methods

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


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