| 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. | |
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MedLine Citation:
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PMID: 18455595 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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 |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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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:
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Created Date: 2008-05-05 Completed Date: 2008-06-03 Revised Date: 2009-07-06 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1137-44, 1144.e1-2 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Surgery, Birmingham Children's Hospital NHS Trust, Birmingham, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Surgical Procedures
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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:
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J Thorac Cardiovasc Surg. 2009 Jul;138(1):257-8
[PMID:
19577105
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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