| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2006;132:845-852
© 2006 The American Association for Thoracic Surgery
Surgery for Congenital Heart Disease |
a Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
b Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
c Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
d Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
e D. Moddemann, Winnipeg, Manitoba; P. Blakley, Saskatoon, Saskatchewan; W. D. Reid, Regina, Saskatchewan.
Received for publication January 26, 2006; accepted for publication May 3, 2006. * Address for reprints: Charlene M. T. Robertson, MD, Room 242, GlenEast, Glenrose Rehabilitation Hospital, 10230-111 Avenue, Edmonton, Alberta T5G 0B7. (Email: croberts{at}cha.ab.ca).
Objectives: This interprovincial inception cohort study outlines the operative and intermediate outcomes of all neonates at a single institution with a broad referral area who underwent the arterial switch operation for transposition of great arteries, including complex types. Predictors of outcome are explored.
Methods: A total of 88 consecutive neonates underwent the arterial switch operation between 1996 and 2004 with full-flow (150 mg/kg/min) cardiopulmonary bypass with selective deep hypothermic circulatory arrest. Overall and event-free survivals were calculated. Health and neurodevelopment (Bayley Scales of Infant Development II) were assessed at 18 to 24 months of age. Univariate and multivariate analyses, sensitivity, and specificity were determined to identify preoperative, intraoperative, and postoperative factors associated with mental and/or motor delay.
Results: There was 1 operative mortality (1.1%). At the average 4-year follow-up, survival was 98.9% and freedom from reintervention was 93.2%. Eighty-five children were assessed. Three were excluded because of unrelated postoperative diagnoses. For the remaining 82, mean scores were 89 ± 17 (49-118) for mental skills and 92 ± 15 (49-125) for motor skills. Anatomic complexity, cardiopulmonary bypass, and deep hypothermic circulatory arrest times were not associated with developmental outcome. Preoperative variables of low gestational age and high preoperative lactate correctly classified 84.1% of mentally and/or motor-delayed children.
Conclusion: Transposition of great arteries, including complex types, can be corrected with low surgical risk and good intermediate survival; however, neurodevelopmental outcome is a concern. These data suggest that although anatomic complexity may not affect late outcome, there may be potentially modifiable preoperative factors that can be optimized to improve developmental outcomes.
This article has been cited by other articles:
|
|
 |
|
  S. Fuller, R. Rajagopalan, G. P. Jarvik, M. Gerdes, J. Bernbaum, G. Wernovsky, R. R. Clancy, C. Solot, S. C. Nicolson, T. L. Spray, et al. Deep Hypothermic circulatory arrest does not impair neurodevelopmental outcome in school-age children after infant cardiac surgery Ann. Thorac. Surg., December 1, 2010; 90(6): 1985 - 1995. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Snookes, J. K. Gunn, B. J. Eldridge, S. M. Donath, R. W. Hunt, M. P. Galea, and L. Shekerdemian A Systematic Review of Motor and Cognitive Outcomes After Early Surgery for Congenital Heart Disease Pediatrics, April 1, 2010; 125(4): e818 - e827. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Joynt, C. M.T. Robertson, P.-Y. Cheung, A. Nettel-Aguirre, A. R. Joffe, R. S. Sauve, W. S.G. Biggs, N. J. Leonard, D. B. Ross, I. M. Rebeyka, et al. Two-year neurodevelopmental outcomes of infants undergoing neonatal cardiac surgery for interrupted aortic arch: A descriptive analysis J. Thorac. Cardiovasc. Surg., October 1, 2009; 138(4): 924 - 932. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Fuller, A. S. Nord, M. Gerdes, G. Wernovsky, G. P. Jarvik, J. Bernbaum, E. Zackai, and J. W. Gaynor Predictors of impaired neurodevelopmental outcomes at one year of age after infant cardiac surgery, Eur J Cardiothorac Surg, July 1, 2009; 36(1): 40 - 48. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. D. H. M. Vandekerckhove, N. A. Blom, S. Lalezari, D. R. Koolbergen, M. E. B. Rijlaarsdam, and M. G. Hazekamp Long-term follow-up of arterial switch operation with an emphasis on function and dimensions of left ventricle and aorta Eur J Cardiothorac Surg, April 1, 2009; 35(4): 582 - 588. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Licht, D. M. Shera, R. R. Clancy, G. Wernovsky, L. M. Montenegro, S. C. Nicolson, R. A. Zimmerman, T. L. Spray, J. W. Gaynor, and A. Vossough Brain maturation is delayed in infants with complex congenital heart defects. J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 529 - 536. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Sherlock, P. S. McQuillen, S. P. Miller, and on behalf of aCCENT Preventing Brain Injury in Newborns With Congenital Heart Disease: Brain Imaging and Innovative Trial Designs Stroke, January 1, 2009; 40(1): 327 - 332. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Neufeld, B. G. Clark, C. M.T. Robertson, D. M. Moddemann, I. A. Dinu, A. R. Joffe, R. S. Sauve, D. E. Creighton, L. Zwaigenbaum, D. B. Ross, et al. Five-year neurocognitive and health outcomes after the neonatal arterial switch operation J. Thorac. Cardiovasc. Surg., December 1, 2008; 136(6): 1413 - 1421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Atallah, I. A. Dinu, A. R. Joffe, C. M.T. Robertson, R. S. Sauve, J. D. Dyck, D. B. Ross, I. M. Rebeyka, and the Western Canadian Complex Pediatric Therapies F Two-Year Survival and Mental and Psychomotor Outcomes After the Norwood Procedure: An Analysis of the Modified Blalock-Taussig Shunt and Right Ventricle-to-Pulmonary Artery Shunt Surgical Eras Circulation, September 30, 2008; 118(14): 1410 - 1418. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Skinner, T. Hornung, and E. Rumball Transposition of the great arteries: from fetus to adult Heart, September 1, 2008; 94(9): 1227 - 1235. [Full Text] [PDF]
|
|
|
|
|
|
E. Angeli, O. Raisky, D. Bonnet, D. Sidi, and P. R. Vouhe Late reoperations after neonatal arterial switch operation for transposition of the great arteries Eur J Cardiothorac Surg, July 1, 2008; 34(1): 32 - 36. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Rastan, T. Walther, N. A. Alam, I. Daehnert, M. A. Borger, F. W. Mohr, J. Janousek, and M. Kostelka Moderate versus deep hypothermia for the arterial switch operation -- experience with 100 consecutive patients Eur J Cardiothorac Surg, April 1, 2008; 33(4): 619 - 625. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Atallah, A. R. Joffe, C. M.T. Robertson, N. Leonard, P. M. Blakley, A. Nettel-Aguirre, R. S. Sauve, D. B. Ross, I. M. Rebeyka, and the Western Canadian Complex Pediatric Therapies P Two-year general and neurodevelopmental outcome after neonatal complex cardiac surgery in patients with deletion 22q11.2: A comparative study J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 772 - 779. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Y. Alton, C. M.T. Robertson, R. Sauve, A. Divekar, A. Nettel-Aguirre, S. Selzer, A. R. Joffe, I. M. Rebeyka, D. B. Ross, and Western Canadian Complex Pediatric Therapies Proje Early childhood health, growth, and neurodevelopmental outcomes after complete repair of total anomalous pulmonary venous connection at 6 weeks or younger J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 905 - 911. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T.R. Roofthooft, K. A. Bergman, T. W. Waterbolk, T. Ebels, B. Bartelds, and R. M.F. Berger Persistent Pulmonary Hypertension of the Newborn With Transposition of the Great Arteries Ann. Thorac. Surg., April 1, 2007; 83(4): 1446 - 1450. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
