Document Detail


The morphologic left ventricle that requires training by means of pulmonary artery banding before the double-switch procedure for congenitally corrected transposition of the great arteries is at risk of late dysfunction.
MedLine Citation:
PMID:  18455595     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to compare the outcome of the double-switch procedure for congenitally corrected transposition of the great arteries for patients completing morphologic left ventricle training by means of pulmonary artery banding with the outcome of patients whose morphologic left ventricle did not require training. METHODS: A retrospective study of all patients undergoing the double-switch procedure from 1991 through 2004 was performed. Patients were divided into 2 groups: those not requiring morphologic left ventricle training (n = 33) and those completing morphologic left ventricle training by means of pulmonary artery banding (n = 11). RESULTS: The time spent with the morphologic left ventricle conditioned at systemic pressures was longer for the group not requiring morphologic left ventricle training (median, 730 days; interquartile range, 399-1234 vs median, 436 days; interquartile range, 411-646; P = .19). The overall mortality (not requiring morphologic left ventricle training, 12.1%; requiring morphologic left ventricle training, 9.1%; P = 1) and rate of death/transplantation, development of moderate-to-severe morphologic left ventricle dysfunction, or both (not requiring morphologic left ventricle training, 21.2%; requiring morphologic left ventricle training, 45.5%; P = .14) were similar between groups. Actuarial freedom from death/transplantation with good morphologic left ventricular function was superior for patients whose morphologic left ventricle did not require training (P = .04). The follow-up was not different between groups (not requiring training: median, 1435 days [interquartile range, 285-2570 days]; requiring morphologic left ventricle training: median, 568 days [interquartile range, 399-1465 days]; P = .14). On multivariate analysis, the completion of morphologic left ventricle training predicted death/transplantation, development of moderate-to-severe morphologic left ventricle dysfunction, or both (P = .02). CONCLUSIONS: The early results of the double-switch procedure in patients whose morphologic left ventricle required training compare favorably with those of patients whose morphologic left ventricle required no training. There is an increased risk of deterioration of morphologic left ventricle function over time in patients whose morphologic left ventricle requires training, and these patients need to be followed up regularly to detect this.
Authors:
David W Quinn; Simon P McGuirk; Chetan Metha; Peter Nightingale; Joseph V de Giovanni; Rami Dhillon; Paul Miller; Oliver Stumper; John G Wright; David J Barron; William J Brawn
Related Documents :
21528635 - Unilateral right occipital condyle to c2 level spinal cord infarction associated with i...
16153285 - Cavo-pulmonary shunt for left ventricular outflow tract obstruction after senning.
7459155 - Aortic atresia occurring with complete transposition of great arteries.
9738755 - The recurrent laryngeal nerve: related vascular anatomy.
3058505 - Local enzymatic treatment of atherosclerotic plaques.
22159745 - The diagnostic value of the doppler ultrasonography in distinguishing the endometrial m...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  135     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-06-03     Revised Date:  2009-07-06    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1137-44, 1144.e1-2     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, Birmingham Children's Hospital NHS Trust, Birmingham, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / adverse effects*,  methods
Child, Preschool
Female
Heart Ventricles / physiopathology
Humans
Infant
Male
Pulmonary Artery / surgery*
Retrospective Studies
Transposition of Great Vessels / surgery*
Ventricular Dysfunction, Left / etiology*,  physiopathology
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2009 Jul;138(1):257-8   [PMID:  19577105 ]

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


Previous Document:  The outcomes of operations for 539 patients with Ebstein anomaly.
Next Document:  Feasibility of the extracardiac conduit Fontan procedure in patients weighing less than 10 kilograms...