Journal article
Persistent risk of subsequent procedures and mortality in patients after interrupted aortic arch repair: A Congenital Heart Surgeons' Society study
The Journal of thoracic and cardiovascular surgery, Vol.140(5), pp.1059-1075.e2
2010
DOI: 10.1016/j.jtcvs.2010.07.067
PMID: 20951256
Abstract
Multiple subsequent procedures directed at the arch and/or the left ventricular outflow tract are frequently required after interrupted aortic arch repair. We the investigated patterns and factors associated with these subsequent procedures and mortality.
We reviewed the data from 447 patients with interrupted aortic arch at 33 institutions enrolled from 1987 to 1997. We classified the subsequent procedures by type (catheter-based or surgical) and focus (arch, left ventricular outflow tract, and “other” cardiovascular lesions). We used competing risks and modulated renewal analysis to explore subsequent procedures.
There were 158 subsequent arch and 100 left ventricular outflow tract procedures. Freedom from death at 21 years was 60% overall. The risk of additional subsequent arch procedures decreased after the first subsequent arch procedure in the acute phase, but did not significantly change in the chronic phase. The risk of additional subsequent left ventricular outflow tract procedures increased after the first subsequent left ventricular outflow tract procedure in the chronic phase. The risk factors for subsequent arch procedures and mortality, but not for subsequent outflow track procedures, were related in a complex way to previous procedures and their timing.
Interrupted aortic arch is a chronic disease in which patients often undergo multiple subsequent procedures with persistent risk for additional intervention and mortality. The risk factors are related to the nature and timing of previous procedures and to the morphology and details of the index procedure. Interrupted aortic arch should be considered a chronic disorder.
Details
- Title: Subtitle
- Persistent risk of subsequent procedures and mortality in patients after interrupted aortic arch repair: A Congenital Heart Surgeons' Society study
- Creators
- Anusha Jegatheeswaran - Division of Cardiovascular Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, CanadaBrian W McCrindle - Division of Cardiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, CanadaEugene H Blackstone - Heart and Vascular Institute and Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OhioMarshall L Jacobs - Pediatric and Congenital Heart Surgery, Cleveland Clinic, Cleveland, OhioGary K Lofland - Department of Cardiothoracic Surgery, Children’s Mercy Hospital, Kansas, MoEarl H Austin - Division of Thoracic and Cardiovascular Surgery, University of Louisville, Louisville, KyThomas Yeh - Division of Cardiothoracic Surgery, Tulane University School of Medicine, New Orleans, LaVictor Morell - Department of Cardiothoracic Surgery, Children’s Hospital of Pittsburgh, Pittsburgh, PaJeffrey P Jacobs - Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Congenital Heart Institute of Florida, All Children’s Hospital and Children’s Hospital of Tampa, Cardiac Surgical Associates of Florida, Saint Petersburg, FlaRichard A Jonas - Division of Cardiac Surgery, Center for Heart, Lung and Kidney Disease, Children’s National Medical, Washington, DCSally Cai - Division of Cardiovascular Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, CanadaJeevanantham Rajeswaran - Heart and Vascular Institute and Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OhioMarco Ricci - Division of Cardiothoracic Surgery, University of Miami Health Systems, Miller School of Medicine, Miami, FlaWilliam G Williams - Division of Cardiovascular Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, CanadaChristopher A Caldarone - Division of Cardiovascular Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, CanadaWilliam M DeCampli - Division of Cardiothoracic Surgery, The Congenital Heart Institute at Arnold Palmer Hospital for Children and University of Central Florida College of Medicine, Orlando, Fla
- Resource Type
- Journal article
- Publication Details
- The Journal of thoracic and cardiovascular surgery, Vol.140(5), pp.1059-1075.e2
- Publisher
- Mosby, Inc
- DOI
- 10.1016/j.jtcvs.2010.07.067
- PMID
- 20951256
- ISSN
- 0022-5223
- eISSN
- 1097-685X
- Language
- English
- Date published
- 2010
- Academic Unit
- Surgery; Cardiothoracic Surgery
- Record Identifier
- 9984051515702771
Metrics
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