Long-Term Results of Arterial Switch Repair of Transposition of the Great Vessels

Blume, Elizabeth D.; Wernovsky, Gil

doi:10.1016/s1092-9126(98)70018-3

Cited by 20 publications

(15 citation statements)

References 111 publications

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“…However, the experience with arterial switch in d-transposition alerts us that late coronary arterial insufficiency (with risk of heart failure, arrhythmia and sudden death), supravalvar aortic stenosis and supravalvar PS associated with arterial switch47 may also occur in ccTGA repair. RV outflow tract obstruction is relatively common after an arterial switch, and an intervention for RV outflow tract or pulmonary artery obstruction or pulmonary regurgitation was necessary in 30% of patients at follow-up 48.…”

Section: Postsurgical Outcomesmentioning

confidence: 99%

Contemporary management and outcomes in congenitally corrected transposition of the great arteries

Kutty

Danford

Diller³

et al. 2018

Heart

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Congenitally corrected transposition of the great arteries (ccTGA) can occur in isolation, or in combination with other structural cardiac anomalies, most commonly ventricular septal defect, pulmonary stenosis and tricuspid valve disease. Clinical recognition can be challenging, so echocardiography is often the means by which definitive diagnosis is made. The tricuspid valve and right ventricle are on the systemic arterial side of the ccTGA circulation, and are therefore subject to progressive functional deterioration. The natural history of ccTGA is also greatly influenced by the nature and severity of accompanying lesions, some of which require surgical repair. Some management strategies leave the right ventricle as the systemic arterial pump, but carry the risk of worsening heart failure. More complex 'double switch' repairs establish the left ventricle as the systemic pump, and include an atrial baffle to redirect venous return in combination with either arterial switch or Rastelli operation (if a suitable ventricular septal defect permits). Occasionally, the anatomic peculiarities of ccTGA do not allow straightforward biventricular repair, and Fontan palliation is a reasonable option. Regardless of the approach selected, late cardiovascular complications are relatively common, so ongoing outpatient surveillance should be established in an age-appropriate facility with expertise in congenital heart disease care.

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Section: Postsurgical Outcomesmentioning

confidence: 99%

Contemporary management and outcomes in congenitally corrected transposition of the great arteries

Kutty

Danford

Diller³

et al. 2018

Heart

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“…HAS BECOME the preferred procedure for surgical management of transposition, defined as the combination of concordant atrioventricular with discordant ventriculo-arterial connections. [2][3][4][5][6] While the postoperative management of these patients is usually straightforward, a small proportion of infants still experience a complicated and prolonged postoperative course. A recent study suggests that longer postoperative cardiac intensive care unit length of stay is independently associated with worse cognitive function at 8 years of age.…”

Section: T He Arterial Switch Operationmentioning

confidence: 99%

Factors prolonging length of stay in the cardiac intensive care unit following the arterial switch operation

Wheeler

Dent

Manning

et al. 2007

CTY

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The arterial switch operation has become the preferred procedure for surgical management of transposition, defined on the basis of concordant atrioventricular and discordant ventriculo-arterial connections. We conducted a retrospective evaluation of our experience in 61 infants with this segmental combination, seen from January, 1997, to July, 2003, in order to determine the factors that are associated with a prolonged postoperative course. Factors independently associated with a prolonged postoperative stay in the cardiac intensive care unit included prematurity, difficulty in feeding, capillary leak, need for preoperative inotropic support, and postoperative infectious complications. Future research is warranted designed to minimize the impact of capillary leak and postoperative infectious complications. In addition, based on these results, our practice has evolved to initiate enteral feedings in the preoperative period if feasible, with such enteral feedings resumed as soon as possible following surgery.

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“…Subsequent contemporary reports have been small and/or limited to single surgical centers. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Hence, the Centers for Disease Control and Prevention has identified linkage of databases to assess the long-term outcomes of persons with CHD as filling a critical gap in knowledge. 16,17 As the oldest, and one of the largest, registries of CHD in the United States, the Pediatric Cardiac Care Consortium (PCCC) is uniquely placed to address the long-term outcomes of these patients.…”

mentioning

confidence: 99%

In‐Hospital Vital Status and Heart Transplants After Intervention for Congenital Heart Disease in the Pediatric Cardiac Care Consortium: Completeness of Ascertainment Using the National Death Index and United Network for Organ Sharing Datasets

Spector

Menk

Vinocur

et al. 2016

JAHA

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Background The long‐term outcomes of patients undergoing interventions for congenital heart disease ( CHD ) remain largely unknown. We linked the Pediatric Cardiac Care Consortium ( PCCC ) with the National Death Index ( NDI ) and the United Network for Organ Sharing Dataset ( UNOS ) registries to study mortality and transplant occurring up to 32 years postintervention. The objective of the current analysis was to determine the sensitivity of this linkage in identifying patients who are known to have died or undergone heart transplant. Methods and Results We used direct identifiers from 59 324 subjects registered in the PCCC between 1982 and 2003 to test for completeness of case ascertainment of subjects with known vital and heart transplant status by linkage with the NDI and UNOS registries. Of the 4612 in‐hospital deaths, 3873 were identified by the NDI as “true” matches for a sensitivity of 84.0% (95% CI, 82.9–85.0). There was no difference in sensitivity across 25 congenital cardiovascular conditions after adjustment for age, sex, race, presence of first name, death year, and residence at death. Of 455 known heart transplants in the PCCC , there were 408 matches in the UNOS registry, for a sensitivity of 89.7% (95% CI , 86.9–92.3). An additional 4851 deaths and 363 transplants that occurred outside the PCCC were identified through 2014. Conclusions The linkage of the PCCC with the NDI and UNOS national registries is feasible with a satisfactory sensitivity. This linkage provides a conservative estimate of the long‐term death and heart transplant events in this cohort.

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Long-Term Results of Arterial Switch Repair of Transposition of the Great Vessels

Cited by 20 publications

References 111 publications

Contemporary management and outcomes in congenitally corrected transposition of the great arteries

Contemporary management and outcomes in congenitally corrected transposition of the great arteries

Factors prolonging length of stay in the cardiac intensive care unit following the arterial switch operation

In‐Hospital Vital Status and Heart Transplants After Intervention for Congenital Heart Disease in the Pediatric Cardiac Care Consortium: Completeness of Ascertainment Using the National Death Index and United Network for Organ Sharing Datasets

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