Faculty Collaboration Database

The arterial switch operation in Europe for transposition of the great arteries: a multi-institutional study from the European Congenital Heart Surgeons Association. J Thorac Cardiovasc Surg 2006 Sep;132(3):633-9

Date

08/29/2006

Pubmed ID

16935120

DOI

10.1016/j.jtcvs.2006.01.065

Scopus ID

2-s2.0-33747789952 (requires institutional sign-in at Scopus site)   91 Citations

Abstract

OBJECTIVES: This study analyzes the results of the arterial switch operation for transposition of the great arteries in member institutions of the European Congenital Heart Surgeons Association.

METHODS: The records of 613 patients who underwent primary arterial switch operations in each of 19 participating institutions in the period from January 1998 through December 2000 were reviewed retrospectively.

RESULTS: A ventricular septal defect was present in 186 (30%) patients. Coronary anatomy was type A in 69% of the patients, and aortic arch pathology was present in 20% of patients with ventricular septal defect. Rashkind septostomy was performed in 75% of the patients, and 69% received prostaglandin. There were 37 hospital deaths (operative mortality, 6%), 13 (3%) for patients with an intact ventricular septum and 24 (13%) for those with a ventricular septal defect (P < .001). In 36% delayed sternal closure was performed, 8% required peritoneal dialysis, and 2% required mechanical circulatory support. Median ventilation time was 58 hours, and intensive care and hospital stay were 6 and 14 days, respectively. Although of various preoperative risk factors the presence of a ventricular septal defect, arch pathology, and coronary anomalies were univariate predictors of operative mortality, only the presence of a ventricular septal defect approached statistical significance (P = .06) on multivariable analysis. Of various operative parameters, aortic crossclamp time and delayed sternal closure were also univariate predictors; however, only the latter was an independent statistically significant predictor of death.

CONCLUSIONS: Results of the procedure in European centers are compatible with those in the literature. The presence of a ventricular septal defect is the clinically most important preoperative risk factor for operative death, approaching statistical significance on multivariable analysis.

Author List

Sarris GE, Chatzis AC, Giannopoulos NM, Kirvassilis G, Berggren H, Hazekamp M, Carrel T, Comas JV, Di Carlo D, Daenen W, Ebels T, Fragata J, Hraska V, Ilyin V, Lindberg HL, Metras D, Pozzi M, Rubay J, Sairanen H, Stellin G, Urban A, Van Doorn C, Ziemer G, European Congenital Heart Surgeons Association

Author

Viktor Hraska MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Europe
Female
Humans
Infant
Infant, Newborn
Male
Multivariate Analysis
Retrospective Studies
Transposition of Great Vessels
Vascular Surgical Procedures