Back to Search
Start Over
Significance of Intraoperative Revision During Arterial Switch Operation in the Current Era.
- Source :
-
World journal for pediatric & congenital heart surgery [World J Pediatr Congenit Heart Surg] 2018 Mar; Vol. 9 (2), pp. 194-200. - Publication Year :
- 2018
-
Abstract
- Background: Arterial switch operation (ASO) is a relatively safe operation nowadays. We hypothesize that intraoperative revision for coronary malperfusion still plays an important role during ASO in the current era.<br />Methods: From January 2005 to May 2016, 244 patients underwent ASO. Medical records were reviewed and the details of intraoperative revision were described. Morbidity and mortality were compared in patients with/without intraoperative revision. Factors related to the need for intraoperative revision were analyzed.<br />Results: Seventeen (7%) patients needed intraoperative revision. As a technique for intraoperative revision, revision of a coronary button was performed in eight patients and revision of the main pulmonary artery anastomosis to relieve compression on the coronary artery was performed in five patients. Factors related to intraoperative revision were body weight at surgery ( P = .051), eccentric position of the coronary ostium ( P = .01), single coronary artery system ( P = .03), and intramural coronary artery ( P = .003). The commonest coronary artery origin and branching pattern was not protective against the need for intraoperative revision ( P = .43). Discharge mortality was 2% overall: 2 of 17 with intraoperative revision versus 3 of 238 without it ( P = .04). Patients who underwent intraoperative revision had longer postoperative hospitalization ( P = .003).<br />Conclusion: The need for intraoperative revision was related to eccentric coronary ostium, single coronary artery, and intramural coronary artery. Although the need for intraoperative revision correlated with higher mortality and morbidity, prompt intraoperative revision also likely contributed to our good results after ASO.
- Subjects :
- Abnormalities, Multiple mortality
Abnormalities, Multiple surgery
Anastomosis, Surgical
Arterial Switch Operation mortality
Coronary Vessel Anomalies mortality
Coronary Vessel Anomalies surgery
Coronary Vessels surgery
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Intraoperative Period
Male
Pulmonary Artery surgery
Retrospective Studies
Treatment Outcome
Arterial Switch Operation methods
Reoperation
Transposition of Great Vessels surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2150-136X
- Volume :
- 9
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- World journal for pediatric & congenital heart surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29544419
- Full Text :
- https://doi.org/10.1177/2150135118754521