Journal article
Multicenter Analysis of Early Childhood Outcomes After Repair of Truncus Arteriosus
The Annals of thoracic surgery, Vol.107(2), pp.553-559
02/2019
DOI: 10.1016/j.athoracsur.2018.08.094
PMID: 30696549
Abstract
Literature describing morbidity and mortality after truncus arteriosus repair is predominated by single-center reports. We created and analyzed a multicenter dataset to identify risk factors for late mortality and right ventricle-to-pulmonary artery (RV-PA) conduit reintervention for this patient population.
We retrospectively collected data on children who underwent repair of truncus arteriosus without concomitant arch obstruction at 15 centers between 2009 and 2016. Cox regression survival analysis was conducted to determine risk factors for late mortality, defined as death occurring after hospital discharge and greater than 30 days after operation. Probability of any RV-PA conduit reintervention was analyzed over time using Fine-Gray modeling.
We reviewed 216 patients with median follow-up of 2.9 years (range, 0.1 to 8.8). Operative mortality occurred in 15 patients (7%). Of the 201 survivors there were 14 (7%) late deaths. DiGeorge syndrome (hazard ratio [HR], 5.4; 95% confidence interval [CI], 1.6 to 17.8) and need for postoperative tracheostomy (HR, 5.9; 95% CI, 1.8 to 19.4) were identified as independent risk factors for late mortality. At least one RV-PA conduit catheterization or surgical reintervention was performed in 109 patients (median time to reintervention, 23 months; range, 0.3 to 93). Risk factors for reintervention included use of pulmonary or aortic homografts versus Contegra (Medtronic, Inc, Minneapolis, MN) bovine jugular vein conduits (HR, 1.9; 95% CI, 1.2 to 3.1) and smaller conduit size (HR per mm/m2, 1.05; 95% CI, 1.03 to 1.08).
In a multicenter dataset DiGeorge syndrome and need for tracheostomy postoperatively were found to be independent risk factors for late mortality after repair of truncus arteriosus, whereas risk of conduit reintervention was independently influenced by both initial conduit type and size.
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Details
- Title: Subtitle
- Multicenter Analysis of Early Childhood Outcomes After Repair of Truncus Arteriosus
- Creators
- Jason R Buckley - Department of Pediatrics, Medical University of South Carolina Children's Hospital, Charleston, South CarolinaVenu Amula - Department of Pediatrics, University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, UtahPeter Sassalos - Department of Cardiac Surgery, University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, MichiganJohn M Costello - Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IllinoisArthur J Smerling - Department of Pediatrics, Columbia University College of Physicians & Surgeons, Morgan Stanley Children's Hospital of New York, New York, New YorkIlias Iliopoulos - Department of Pediatrics, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OhioAimee Jennings - Department of Pediatrics, Seattle Children’s Hospital, Seattle, WashingtonChristine M Riley - Department of Pediatrics, Children's National Health System, Washington, DCKatherine Cashen - Department of Pediatrics, Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MichiganSukumar Suguna Narasimhulu - Department of Pediatrics, University of Central Florida College of Medicine, The Heart Center at Arnold Palmer Hospital for Children, Orlando, FloridaKeshava Murthy Narayana Gowda - Department of Pediatrics, Cleveland Clinic, Cleveland, OhioAdnan M Bakar - Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Cohen Children's Medical Center of New York, New Hyde Park, New YorkMichael Wilhelm - Department of Pediatrics, University of Wisconsin, Madison, WisconsinAditya Badheka - Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IowaElizabeth A.S Moser - Department of Biostatistics, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, IndianaChristopher W Mastropietro - Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IndianaCollaborative Research in Pediatric Cardiac Intensive Care Investigators
- Resource Type
- Journal article
- Publication Details
- The Annals of thoracic surgery, Vol.107(2), pp.553-559
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.athoracsur.2018.08.094
- PMID
- 30696549
- ISSN
- 0003-4975
- eISSN
- 1552-6259
- Language
- English
- Date published
- 02/2019
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics
- Record Identifier
- 9984093223602771
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