Balloon atrial septostomy and pre-operative brain injury in neonates with transposition of the great arteries: a systematic review and a meta-analysis

Polito, Angelo; Ricci, Zaccaria; Fragasso, Tiziana; Cogo, Paola

doi:10.1017/s1047951111001909

Cited by 25 publications

(18 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While Pasquali et al found that patients with transposition of the great arteries and single coronary or intramural coronary anatomy had a higher mortality compared with other types of coronary anatomy, more recent studies have not shown a correlation between coronary anatomy and mortality in patients with dextro-transposition of the great arteries. [14][15][16][17] In 2001, Brown et al 18 suggested that modern coronary reimplantation techniques have minimised coronary anomalies as a significant risk factor for mortality in patients undergoing the arterial switch operation. This suggests that having a cardiac catheterisation to identify coronary anatomy before the arterial switch operation may not be necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Of these patients, six were found to have coronary anomalies at the time of the arterial switch, but there were no surgical complications related to the coronary anatomy. While Pasquali et al found that patients with transposition of the great arteries and single coronary or intramural coronary anatomy had a higher mortality compared with other types of coronary anatomy, more recent studies have not shown a correlation between coronary anatomy and mortality in patients with dextro-transposition of the great arteries 14 17 In 2001, Brown et al 18 suggested that modern coronary reimplantation techniques have minimised coronary anomalies as a significant risk factor for mortality in patients undergoing the arterial switch operation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

No difference found in safety or efficacy of balloon atrial septostomy performed at the bedside versus the catheterisation laboratory

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

No difference found in safety or efficacy of balloon atrial septostomy performed at the bedside versus the catheterisation laboratory

et al. 2018

View full text Add to dashboard Cite

show abstract

“…and others demonstrated that BAS is associated with increased risk of stroke in neonates with TGA. In contrast, a recent meta‐analysis found no significant association between BAS and brain injury. As this possible association was still debated in the literature at the time of planning our systematic review, we decided to exclude cases where BAS was performed, to avoid overestimating the prevalence of preoperative brain injury in cases with TGA.…”

Section: Discussionmentioning

confidence: 99%

Brain abnormalities and neurodevelopmental delay in congenital heart disease: systematic review and meta-analysis

Khalil

Suff

Thilaganathan

et al. 2013

Ultrasound Obstet Gynecol

164

140

View full text Add to dashboard Cite

show abstract

“…Some reports suggest that embolic brain injury is related to BAS [27, 28] although this has been refuted by others [29–31]. …”

Section: Preoperative Carementioning

confidence: 99%

D-Transposition of the Great Arteries

Villafañe

Lantin‐Hermoso

Bhatt

et al. 2014

Journal of the American College of Cardiology

246

View full text Add to dashboard Cite

Objectives This paper aims to update clinicians on “Hot Topics” in the management of patients with d-transposition of the great arteries (D-TGA) in the current surgical era. Background The arterial switch operation (ASO) has replaced atrial switch procedures for D-TGA and 90% of patients now reach adulthood. Methods The Adult Congenital and Pediatric Cardiology Council (ACPC) of the American College of Cardiology assembled a team of experts to summarize current knowledge on genetics, prenatal diagnosis, surgical timing, balloon atrial septostomy (BAS), prostaglandin therapy (PGE), intraoperative techniques, imaging, coronary obstruction, arrhythmias, sudden death, aortic dilation and regurgitation (AR), neurodevelopmental (ND) issues and lifelong care of D-TGA patients. Results In simple D-TGA, 1) familial recurrence risk is low; 2) children diagnosed prenatally have improved cognitive skills compared with those diagnosed postnatally; 3) echocardiography helps to identify risk factors; 4) routine use of BAS and PGE may not be beneficial in some cases; 5) early ASO improves outcomes and reduces costs with a low mortality. Single or intramural coronary arteries remain risk factors; 6) post-ASO arrhythmias and cardiac dysfunction should raise suspicion of coronary insufficiency; 7) coronary insufficiency and arrhythmias are rare but associated with sudden death; 8) early and late-onset ND abnormalities are common; 9) AR and aortic root dilation are well tolerated; and 10) the aging ASO patient may benefit from “exercise-prescription” rather than restriction. Conclusions Significant strides have been made in understanding risk factors for cardiac, ND and other important clinical outcomes after ASO.

show abstract

Balloon atrial septostomy and pre-operative brain injury in neonates with transposition of the great arteries: a systematic review and a meta-analysis

Abstract: Our analysis shows that balloon atrial septostomy is not associated with increased odds for peri-operative brain injury. Balloon atrial septostomy should still be used for those patients with significant hypoxaemia, haemodynamic instability, or both.

Cited by 25 publications

References 19 publications

No difference found in safety or efficacy of balloon atrial septostomy performed at the bedside versus the catheterisation laboratory

No difference found in safety or efficacy of balloon atrial septostomy performed at the bedside versus the catheterisation laboratory

Brain abnormalities and neurodevelopmental delay in congenital heart disease: systematic review and meta-analysis

D-Transposition of the Great Arteries

Contact Info

Product

Resources

About