Anatomical risk factors for mortality and cardiac morbidity after arterial switch operation

Daebritz, Sabine; Nollert, Georg; Sachweh, Jörg S; Engelhardt, W; Bernuth, G. von; Messmer, Bruno J.

doi:10.1016/s0003-4975(00)01241-8

Cited by 110 publications

(84 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Technical difficulties have been overcome by surgical experience and appropriate techniques 3 and as a result, the mortality rate has been reduced to less than 10%. 4 Although the concept of the repair of TGA has remained unchanged since Jatene, many surgeons have proposed different techniques in order to prevent the occurrence of coronary ischemia.…”

Section: Discussionmentioning

confidence: 99%

Arterial Switch Operations for Single Coronary Artery Ostium or Intramural Coronary Artery

Çetin¹,

Tirelı

Özkara³

et al. 2004

Circ J

View full text Add to dashboard Cite

ecently, the arterial switch operation has become the first line surgical procedure for the correction of transposition of the great arteries (TGA) 1 and the determinants of success are the preoperative left ventricular performance, coronary artery anatomy and the experience of the surgical team. Complex coronary artery anatomy increases the operative risk. 1 Following repair of TGA with the usual coronary artery pattern in which the right and left coronary arteries arise from sinuses I and II respectively, kinking or tension of the coronary arteries is rarely seen; however, the risk increases in TGA with a single coronary ostium or intramural coronary artery patterns.

show abstract

Section: Discussionmentioning

confidence: 99%

Arterial Switch Operations for Single Coronary Artery Ostium or Intramural Coronary Artery

Çetin¹,

Tirelı

Özkara³

et al. 2004

Circ J

View full text Add to dashboard Cite

show abstract

“…This was probably due to an institutional referral pattern which distorts the usual case mix [13,16]. The presence of an associated coarctation, independently from the management strategy, was not a significant risk factor for both mortality and reoperation.…”

Section: Discussionmentioning

confidence: 99%

Transposition of the great arteries associated with ventricular septal defect: surgical results and long-term outcome

Wetter

Belli

Sinzobahamvya

et al. 2001

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

Objectives: To identify potential risk factors influencing early and late outcome following the arterial switch operation (ASO) for transposition of the great arteries associated with ventricular septal defect including double-outlet right or left ventricle. Methods: All patients who underwent ASO in our department until August 2000 (n ¼ 105) were included in this study. There were 77 transpositions of the great arteries with ventricular septal defect, 22 Taussig-Bing hearts and six patients with double-outlet morphology. The median age at operation was 24 days. Aortic arch obstruction was present in 25 patients; in 13 of these patients, a repair with aortic arch reconstruction was done before ASO. The usual coronary artery pattern was present in 59% of the patients. In six patients, we found an intramural course of at least one coronary artery. The ventricular septal defect was closed with a patch through the right atrium (n ¼ 35), the aorta (n ¼ 25), the pulmonary artery (n ¼ 25) or the right ventricle (n ¼ 3); in 17 patients a combined approach was necessary. Results: There were five hospital deaths (4.7%, 95% confidence limit 2-11%). The median duration of follow-up was 72 months. Fourteen patients underwent 15 reoperations 33 months after repair (median), eight for right ventricular outflow tract obstruction or neopulmonary stenosis. Four late deaths occurred, two due to complications related to coronary artery anomalies. Statistical analysis revealed no significant risk factor whatsoever correlating with death or need for reoperation. Survival after 12 years was 91.6%, and freedom from reoperation was 82.6%. Latest follow-up data showed that 13% of patients were in NYHA class II and/or required medical treatment; 87% were in NYHA class I. Conclusions: ASO associated with patch closure of ventricular septal defect can be performed early in life with a low risk of mortality (,5%), low incidence of reintervention (,15%) and promising long-term outcome. q 2001 Published by Elsevier Science B.V.

show abstract

“…[2,12] In general, the unfavorable left ventricular geometry is accepted as a contraindication for the primary ASO; however, it is reported to be transient and can be treated by pharmacological means and ECMO support. [12] This change in the left ventricular shape is due to low afterload, but not an intrinsic change in the left ventricular myocardial properties, and it is reversible.…”

Section: Discussionmentioning

confidence: 99%

“…[1] The arterial switch operation (ASO) became the first choice for correction of TGA. [2,3] However, the feasibility of this operation after postnatal three weeks of age is still controversial. There are articles advocating atrial switch or two-stage ASO in children presenting late with TGA.…”

mentioning

confidence: 99%

Late primary arterial switch operation in patients with transposition of great arteries and intact ventricular septum

Yıldız¹

2016

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

ÖZAmaç: Bu çalışmada büyük damarların transpozisyonu ve intakt ventriküler septumlu hastalarda yaşamın üçüncü haftasından sonra yapılan geç dönem arteriyel switch ameliyatı sonuçları sunuldu.Ça lış ma pla nı: Ocak 2010 -Kasım 2015 tarihleri arasında, hastanenin veri tabanı kullanılarak doğum sonrası üçüncü haftada büyük damarların transpozisyonu ve intakt ventriküler septum tanısı ile arteriyel switch ameliyatı yapılan toplam 14 hasta (8 erkek, 6 kız; ort. yaş 42 gün; dağılım 22-125 gün) geriye dönük olarak incelendi. Bul gu lar:Başlangıçta sekiz hastada şiddetli siyanoz (SO 2 ≤%70) vardı, 11 hasta prostaglandin E 1 infüzyonu kullanıyordu ve dört hastaya mekanik ventilasyon desteği verilmekteydi. Üç hastaya daha önce balon atriyal septostomi yapılmıştı. Dört hastaya ameliyat öncesi kardiyak kateterizasyon uygulandı. Ameliyat sonrası 12 hasta sternum açık şekilde yoğun bakım ünitesine nakledildi. Medyan mekanik ventilasyon, yoğun bakım ünitesi ve hastanede kalış süreleri sırası ile yedi gün, 12 gün ve 17 gün idi. Üç hastaya periton diyalizi yapıldı. Yoğun bakım ünitesinde kalınan süre içerisinde üç hastada ritim sorunu ve üç hastada sepsis gelişti. Bir hastada ekstra korporeal yaşam desteği gereksinimi doğdu. Hiçbir hastada mortalite gözlenmedi.So nuç: Ayrıntılı ameliyat öncesi değerlendirme sonrasında ve etkili, gelişmiş ve uygun ameliyat sonrası yoğun bakım ünitesinde monitörizasyon ile büyük damarların transpozisyonu ve intakt ventriküler septumlu hastalarda geç dönemde arteriyel switch ameliyatı güvenle uygulanabilir.Anah tar söz cük ler: Arteriyel switch ameliyatı; yenidoğan; büyük arterlerin transpozisyonu. ABSTRACTBackground: This study aims to report the results of late arterial switch operation performed in patients with transposition of the great arteries and intact ventricular septum after the third week of life.

show abstract

Anatomical risk factors for mortality and cardiac morbidity after arterial switch operation

Cited by 110 publications

References 13 publications

Arterial Switch Operations for Single Coronary Artery Ostium or Intramural Coronary Artery

Arterial Switch Operations for Single Coronary Artery Ostium or Intramural Coronary Artery

Transposition of the great arteries associated with ventricular septal defect: surgical results and long-term outcome

Late primary arterial switch operation in patients with transposition of great arteries and intact ventricular septum

Contact Info

Product

Resources

About