Morbilidad y mortalidad de los pacientes con transposición completa de grandes arterias intervenidos mediante cirugía de corrección arterial

Puras, María José Rodríguez; Cabeza-Letrán, Luisa; Romero-Vazquiánez, Manuela; Soto, José Santos de; Hosseinpour, Reza; Fournier, Mauro Gil; Madrid, Antonio; González, Antonio; Pérez, Pilar; Gallego, Pastora

doi:10.1016/j.recesp.2013.06.024

Cited by 14 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Late mortality of arterial switch survivors is almost universally exceptionally low, despite the size and expertise of the center [7,9,10,12,14,15,21,[24][25][26][27]. This is also true in our experience.…”

Section: Discussionsupporting

confidence: 56%

“…However, other authors from small and medium case-load centers have reported overall surgical mortalities ranging from 4.8 to 28% [14,[20][21][22]. Similar to the experience of large centers, surgical mortality rates tend to decrease with time [14,15,20,21]. Shim et al reported that two out of three patients who died during the 30 post-operative days were operated on at the beginning of the arterial switch program [15].…”

Section: Discussionmentioning

confidence: 84%

“…Shim et al reported an astonishing mortality rate of 2.2% among a cohort of 139 patients who underwent an arterial switch operation between 1995 and 2014 in South Korea [15]. However, other authors from small and medium case-load centers have reported overall surgical mortalities ranging from 4.8 to 28% [14,[20][21][22]. Similar to the experience of large centers, surgical mortality rates tend to decrease with time [14,15,20,21].…”

Section: Discussionmentioning

confidence: 90%

“…The majority (79.5%) of patients underwent neonatal arterial switch. At the time of operation, the median age was 13 days (IQR, [9][10][11][12][13][14][15][16][17][18][19][20][21][22], and the median weight was 3.5 kg (IQR, 3.2-3.9). The most frequent prior procedure was a Rashkind balloon atrial septostomy performed in 62 (48.8%) patients.…”

Section: Resultsmentioning

confidence: 99%

“…Shim et al reported that two out of three patients who died during the 30 post-operative days were operated on at the beginning of the arterial switch program [15]. Puras et al reported a decrease in surgical mortality rates from 19% in patients operated on between 1985 and 1998 to 8% in patients operated on between 1998 and 2010 [21]. Manso et al documented a drastic decrease in surgical mortality from 44% to 25% to 16% in patients operated on between 1995 and 2004, 2005-2008, and 2009-2014, respectively [14].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Early and Late Outcomes after Arterial Switch Operation: A 40-Year Journey in a Single Low Case Volume Center

et al. 2021

View full text Add to dashboard Cite

Background and Objectives: The results of the arterial switch operation in large congenital heart centers are excellent, and the results in small and medium centers are improving. The objective of this article is to share our experience utilizing the international knowledge transfer program to improve early and late arterial switch operation outcomes in our center. Materials and Methods: A retrospective analysis of patients who underwent the arterial switch operation in Vilnius University Santaros Clinics Cardiothoracic Surgery Center between 1977–2020 was performed. Results: A total of 127 consecutive arterial switch operations were performed in our center. Surgical mortality during the entire study period was 24.6%. Surgical mortality prior to the program, during the program, and after the program was 88.24%, 41.7%, and 5.81%, respectively (p < 0.0001). The surgical mortality of patients operated on during the last 10 years was 4%. The overall survival estimate for the 97 surviving patients was 96.9%, 94.9%, 93.8%, 93.8%, 93.8%, 93.8% at 1, 3, 5, 10, 15, and 20 years, respectively. Risk factors for early mortality included longer aortic cross-clamp time and operation prior to the knowledge transfer program. The only significant risk factor for late reintervention was concomitant aortic arch obstruction treated at the time of the arterial switch. Conclusions: The surgical treatment of transposition of the great arteries by means of an arterial switch with good results can be possible in low-to-medium volume congenital heart surgery centers. International knowledge transfer programs between high-expertise high-volume congenital heart centers and low-to-medium volume congenital heart centers may help to shorten the learning curve and improve early and late outcomes after an arterial switch. The risk factors for surgical mortality and intervention-free survival in low-volume surgical centers are similar to those in high-volume centers. Late arterial switch-related complications are similar to those among different-sized congenital heart centers.

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Early and Late Outcomes after Arterial Switch Operation: A 40-Year Journey in a Single Low Case Volume Center

et al. 2021

View full text Add to dashboard Cite

show abstract

Outcomes of Patients After Arterial Switch Operation: 18 Years of Experience in a Single Medium-Volume Center

et al. 2015

View full text Add to dashboard Cite

The objective of this paper was to describe the outcomes in patients submitted to arterial switch operation and to analyze the predictors of in-hospital mortality and further need of re-operation at a single-center institution. Between September 1995 and January 2014, 128 consecutive arterial switch operations were performed. Surgical mortality during this period was analyzed retrospectively, and a follow-up analysis of the survivors was conducted. Surgical era, cardiopulmonary bypass time (p = 0.001), and diagnosis category (p = 0.025) influenced in-hospital mortality. The estimated overall survival for the 91 hospital survivors was 96.8, 96.4, and 96.2 % at 5, 10, and 15 years, respectively. The median follow-up time was 67 months (range 0.71-222 months). Three patients (5 %) presented severe aortic regurgitation. Right ventricle outflow tract systolic gradient by echocardiography was above 60 mmHg in 2 %. Late re-interventions occurred in 12 (13 %) patients with mean time of 64 ± 34 months after the initial procedure. Actuarial freedom from re-interventions at 5, 10, and 15 years was 96.4, 69.7, and 61.9 %, respectively. Arterial switch operation remains the procedure of choice in patients with transposition of great arteries. It can be performed even in middle-volume institutions, leading to the same middle- and long-term outcomes of high-volume institutions. Early high mortality rate may occur due not only to learning curve, but also to cardiopulmonary bypass time and ventricular septal defect closure.

show abstract

Arrhythmien bei Erwachsenen mit angeborenen Herzfehlern

Wasmer

Köbe

Diller

et al. 2016

Herzschr Elektrophys

View full text Add to dashboard Cite

Arrhythmia management is one of the main challenges in the treatment of adult patients with congenital heart disease (ACHD). Apart from heart failure, arrhythmias are mainly responsible for morbidity and mortality in these patients. Supraventricular tachycardia is more frequent than ventricular arrhythmias and is not only associated with debilitating symptoms, but is often as threatening as ventricular tachycardia. The incidence depends on the underlying defect, type, and time of repair. For the overall ACHD population the incidence of supraventricular tachycardia is up to 50 % and increases with age and time since surgery. Arrhythmia substrate relates to structural abnormalities due to the congenital defect and most importantly to the amount of incisions and material used for repair. In addition, poor hemodynamic conditions influence substrate through dilatation, hypertrophy, and fibrosis. Both supraventricular and ventricular arrhythmias are due to a macroreentrant mechanism in the vast majority of patients, but focal arrhythmias occasionally occur as well.

show abstract

Morbilidad y mortalidad de los pacientes con transposición completa de grandes arterias intervenidos mediante cirugía de corrección arterial

Cited by 14 publications

References 21 publications

Early and Late Outcomes after Arterial Switch Operation: A 40-Year Journey in a Single Low Case Volume Center

Early and Late Outcomes after Arterial Switch Operation: A 40-Year Journey in a Single Low Case Volume Center

Outcomes of Patients After Arterial Switch Operation: 18 Years of Experience in a Single Medium-Volume Center

Arrhythmien bei Erwachsenen mit angeborenen Herzfehlern

Contact Info

Product

Resources

About