PMID- 34278862
OWN - NLM
STAT- MEDLINE
DCOM- 20220217
LR  - 20220217
IS  - 2150-136X (Electronic)
IS  - 2150-1351 (Linking)
VI  - 12
IP  - 4
DP  - 2021 Jul
TI  - Risk Factors for Reoperation After Arterial Switch Operation.
PG  - 463-470
LID - 10.1177/21501351211009768 [doi]
AB  - OBJECTIVE: The timing and nature of and risk factors for reoperation after the 
      arterial switch operation in the setting of d-transposition of the great arteries 
      requires further elucidation. METHODS: A total of 403 patients who underwent 
      arterial switch operation from 1986 to 2017 were reviewed. Institutional 
      preference was for pulmonary artery reconstruction using a pantaloon patch of 
      fresh autologous pericardium. The targets for coronary artery reimplantation were 
      identified by intermittent root distension. Multivariable analysis was used to 
      identify risk factors for reoperation. RESULTS: Median follow-up was 8.6 years 
      (interquartile range [IQR]: 2-16.9). Pulmonary arterioplasty was the most common 
      reoperation (n = 11, 2.7%) at 3.3 years (IQR: 1.4-11.4) postoperatively. 
      Subvalvar right ventricular outflow tract reconstruction (RVOTR) was required in 
      nine (2.2%) patients at 2.5 years (IQR: 1.1-5.3) postoperatively. Aortic valve 
      repair or replacement (AVR/r) was required in seven (1.7%) patients at 13.6 years 
      (IQR: 10.0-15.8) postoperatively. Aortic root replacement (ARR) and Coronary 
      Artery Bypass Graft/coronary patch arterioplasty were required in five (1.2%) 
      patients each at 13.6 years (IQR: 11.0-15.3) and 11.3 years (IQR: 2.3-13.6) 
      postoperatively, respectively. Taussig-Bing anomaly was a risk factor for any 
      reoperation (P = .034). Risk factors for specific reoperations included 
      ventricular septal defect for AVR/r (P = .038), Taussig-Bing anomaly for RVOTR (P 
      = .004), and pulmonary artery banding for ARR (P = .028). CONCLUSIONS: Pantaloon 
      patch pulmonary artery reconstruction and intermittent neo-aortic root distension 
      during coronary reimplantation have minimized respective outflow tract 
      reoperations. Certain anatomic subsets carry different risks for late 
      reoperation, and pulmonary artery and/or RVOT reinterventions tend to occur 
      sooner than aortic reinterventions. Special attention to these higher risk 
      subpopulations will be critical to optimizing lifelong outcomes.
FAU - Patel, Parth M
AU  - Patel PM
AUID- ORCID: 0000-0003-3198-1916
AD  - Division of Thoracic and Cardiovascular Surgery, 12250Indiana University School 
      of Medicine, Indianapolis, IN, USA.
AD  - * These two authors contributed equally to this work.
FAU - Herrmann, Jeremy L
AU  - Herrmann JL
AUID- ORCID: 0000-0001-7818-0548
AD  - Division of Thoracic and Cardiovascular Surgery, 12250Indiana University School 
      of Medicine, Indianapolis, IN, USA.
AD  - 22536Riley Children's Health at Indiana University Health, Indianapolis, IN, USA.
AD  - * These two authors contributed equally to this work.
FAU - Bain, Eric
AU  - Bain E
AD  - Division of Thoracic and Cardiovascular Surgery, 12250Indiana University School 
      of Medicine, Indianapolis, IN, USA.
FAU - Ladowski, Joseph M
AU  - Ladowski JM
AD  - Division of Thoracic and Cardiovascular Surgery, 12250Indiana University School 
      of Medicine, Indianapolis, IN, USA.
FAU - Colgate, Cameron
AU  - Colgate C
AD  - Division of Thoracic and Cardiovascular Surgery, 12250Indiana University School 
      of Medicine, Indianapolis, IN, USA.
FAU - Rodefeld, Mark D
AU  - Rodefeld MD
AD  - Division of Thoracic and Cardiovascular Surgery, 12250Indiana University School 
      of Medicine, Indianapolis, IN, USA.
AD  - 22536Riley Children's Health at Indiana University Health, Indianapolis, IN, USA.
FAU - Turrentine, Mark W
AU  - Turrentine MW
AD  - Division of Thoracic and Cardiovascular Surgery, 12250Indiana University School 
      of Medicine, Indianapolis, IN, USA.
AD  - 22536Riley Children's Health at Indiana University Health, Indianapolis, IN, USA.
FAU - Brown, John W
AU  - Brown JW
AD  - Division of Thoracic and Cardiovascular Surgery, 12250Indiana University School 
      of Medicine, Indianapolis, IN, USA.
AD  - 22536Riley Children's Health at Indiana University Health, Indianapolis, IN, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Pediatr Congenit Heart Surg
JT  - World journal for pediatric & congenital heart surgery
JID - 101518415
SB  - IM
MH  - *Arterial Switch Operation/adverse effects
MH  - Follow-Up Studies
MH  - Humans
MH  - Infant
MH  - Reoperation
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Transposition of Great Vessels/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - adult congenital heart disease
OT  - aortic root
OT  - arterial switch operation
OT  - pulmonary stenosis
OT  - reoperation
EDAT- 2021/07/20 06:00
MHDA- 2022/02/19 06:00
CRDT- 2021/07/19 08:41
PHST- 2021/07/19 08:41 [entrez]
PHST- 2021/07/20 06:00 [pubmed]
PHST- 2022/02/19 06:00 [medline]
AID - 10.1177/21501351211009768 [doi]
PST - ppublish
SO  - World J Pediatr Congenit Heart Surg. 2021 Jul;12(4):463-470. doi: 
      10.1177/21501351211009768.