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Göteborgs universitets publikationer

The arterial switch operation in Europe for transposition of the great arteries: a multi-institutional study from the European Congenital Heart Surgeons Association.

Författare och institution:
George E Sarris (-); Andrew C Chatzis (-); Nicolas M Giannopoulos (-); George Kirvassilis (-); Håkan Berggren (Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin); Mark Hazekamp (-); Thierry Carrel (-); Juan V Comas (-); Duccio Di Carlo (-); Willem Daenen (-); Tjark Ebels (-); Josè Fragata (-); Victor Hraska (-); Vladimir Ilyin (-); Harald L Lindberg (-); Dominique Metras (-); Marco Pozzi (-); Jean Rubay (-); Heikki Sairanen (-); Giovanni Stellin (-); Andreas Urban (-); Carin Van Doorn (-); Gerhard Ziemer (-)
Publicerad i:
The Journal of thoracic and cardiovascular surgery, 132 ( 3 ) s. 633-9
Artikel, refereegranskad vetenskaplig
Sammanfattning (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.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Europe, Female, Humans, Infant, Infant, Newborn, Male, Multivariate Analysis, Retrospective Studies, Transposition of Great Vessels, surgery, Vascular Surgical Procedures, methods
Postens nummer:
Posten skapad:
2007-10-22 11:28
Posten ändrad:
2011-01-20 09:58

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