TY - JOUR
T1 - Incidence and Risk Factors for Right Ventricular Outflow Tract Obstruction after the Arterial Switch Operation
AU - Cleuziou, Julie
AU - Vitanova, Keti
AU - Pabst Von Ohain, Jelena
AU - Ono, Masamichi
AU - Tanase, Daniel
AU - Burri, Melchior
AU - Lange, Rüdiger
N1 - Publisher Copyright:
© 2019 by Georg Thieme Verlag KG, Stuttgart - New York.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background The aim of this study was to evaluate the incidence and risk factors for the development of right ventricular outflow tract obstruction (RVOTO) after the arterial switch operation (ASO). Methods Between 1983 and 2014, a total of 688 patients underwent ASO. RVOTO was defined as any obstruction of the right ventricular outflow tract (RVOT) requiring reintervention. Results RVOTO developed in 79 patients (11%) at a median time of 3.8 years (range, 1 day-23.6 years) after ASO. Freedom from RVOT reintervention was 96 ± 1, 89 ± 1, and 83 ± 2% at 1, 10, and 25 years, respectively. Independent risk factors for the development of RVOTO in a Cox's regression model were side-by-side great arteries (p < 0.001), aortic arch anomalies (p < 0.001), use of a pericardial patch for augmentation of the coronary buttons (p < 0.001), and a peak gradient more than 20 mm Hg over the RVOT at discharge (p < 0.001). Conclusion The incidence of RVOTO after ASO is not negligible. Complex morphology, such as side-by-side great arteries and aortic arch anomalies influences the development of RVOTO.
AB - Background The aim of this study was to evaluate the incidence and risk factors for the development of right ventricular outflow tract obstruction (RVOTO) after the arterial switch operation (ASO). Methods Between 1983 and 2014, a total of 688 patients underwent ASO. RVOTO was defined as any obstruction of the right ventricular outflow tract (RVOT) requiring reintervention. Results RVOTO developed in 79 patients (11%) at a median time of 3.8 years (range, 1 day-23.6 years) after ASO. Freedom from RVOT reintervention was 96 ± 1, 89 ± 1, and 83 ± 2% at 1, 10, and 25 years, respectively. Independent risk factors for the development of RVOTO in a Cox's regression model were side-by-side great arteries (p < 0.001), aortic arch anomalies (p < 0.001), use of a pericardial patch for augmentation of the coronary buttons (p < 0.001), and a peak gradient more than 20 mm Hg over the RVOT at discharge (p < 0.001). Conclusion The incidence of RVOTO after ASO is not negligible. Complex morphology, such as side-by-side great arteries and aortic arch anomalies influences the development of RVOTO.
KW - neonate
KW - right ventricular outflow tract
KW - transposition of the great arteries
UR - http://www.scopus.com/inward/record.url?scp=85046411415&partnerID=8YFLogxK
U2 - 10.1055/s-0038-1645877
DO - 10.1055/s-0038-1645877
M3 - Article
C2 - 29715702
AN - SCOPUS:85046411415
SN - 0171-6425
VL - 67
SP - 37
EP - 43
JO - Thoracic and Cardiovascular Surgeon
JF - Thoracic and Cardiovascular Surgeon
IS - 1
ER -