Factores de riesgo de la corrección anatómica para la transposición de grandes arterias

Hernández, J.A. García; Valladares, Cristina Montero; López, Adoración I. Martínez; Parreño, A. Romero; Montero, Josefina Grueso; Carazo, Mauro Gil-Fournier; Domínguez, Aurelio Cayuela; Abril, M. Loscertales; Santos, Aníbal Tovaruela

doi:10.1157/13077233

Cited by 8 publications

(2 citation statements)

References 23 publications

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“…[ 9 ] However, the length of the stay of postoperative patients in ICU in the first few years after arterial switch surgery in another center was reported to be longer and the length of stay in ICU decreased over time, as the experience of the center increased. [ 10 ] Since our center is a newly established center, we have been more cautious about discharging our patients from ICU and the hospital. From this point of view, the relatively prolonged stay in ICU is compatible with the literature.…”

Section: Discussionmentioning

confidence: 99%

Is arterial switch operation possible with neonatology-focused intensive care unit modality

Doyurgan¹,

Özdemir²,

Akdeniz³

et al. 2021

Turk Gogus Kalp Dama

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Background: In this study, we aimed to examine the feasibility of arterial switch operation and its perioperative management with neonatology-focused intensive care modality in a region of Turkey where the birth rate and the number of asylum seekers who had to leave their country due to regional conflicts are high. Methods: Between December 2017 and June 2020, a total of 57 patients (48 males, 9 females; median age: 12.2 days; range, 2 to 50 days) who were diagnosed with transposition of the great arteries in our clinic and underwent arterial switch operation were retrospectively analyzed. All patients were followed by the neonatologist in the neonatal intensive care unit during the preoperative and postoperative period. Results: Thirty-eight (66.7%) patients had intact ventricular septum, 16 (28.1%) had ventricular septal defect, two (3.5%) had coarctation of the aorta, and one (1.7%) had Taussig-Bing anomaly. Coronary artery anomaly was present in 14 (24.5%) patients. The most common complications in the intensive care unit were renal failure requiring peritoneal dialysis in seven (12.3%) patients, supraventricular tachyarrhythmia in six (10.5%) patients, and eight (14%) patients left their chests open. The median length of stay in intensive care unit was 13.8 (range, 9 to 25) days and the median length of hospital stay was 24.5 (range, 16 to 47) days. The overall mortality rate for all patients was 12.3% (n=7). The median follow-up was 8.2 months. A pulmonary valve peak Doppler gradient of ≥36 mmHg was detected in five patients (8.7%) who were followed, and these patients were monitored by providing medical treatment. None of the patients needed reoperation or reintervention. Conclusion: We believe that arterial switch operation, one of the complex neonatal cardiac surgery, can be performed with an acceptable mortality and morbidity rate with the use of neonatology-focused intensive care modality, which is supported by pediatric cardiology and pediatric cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Is arterial switch operation possible with neonatology-focused intensive care unit modality

Doyurgan¹,

Özdemir²,

Akdeniz³

et al. 2021

Turk Gogus Kalp Dama

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“…Coronary artery abnormalities, and particularly intramural coronary artery, have been widely acknowledged as very important risk factors for surgical complications in TGA [17,39,40], and in some postmortem and postnatal series, these abnormalities have been found to be more common when the great arteries are arranged either side by side, or when the aorta is anterior to and to the left of the pulmonary artery, or when the aorta is posterior to and to the right of the pulmonary artery [15,16]. These relationships have led some authors to recommend the prenatal study of the spatial arrangement of the great arteries to identify those fetuses with the highest risk for these conditions.…”

Section: Discussionmentioning

confidence: 99%

Transposition of the Great Arteries in Fetal Life: Accuracy of Diagnosis and Short-Term Outcome

Domínguez-Manzano

Mendoza²,

Herraı̀z³

et al. 2016

Fetal Diagn Ther

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Objective: To review our series of prenatally diagnosed transposition of the great arteries (TGA) to analyze the accuracy of fetal echocardiography for achieving a precise diagnosis of the TGA type (simple vs. complex) and to examine the short-term outcome. Methods: A total of 94 cases of simple and complex TGA types (ventriculoarterial discordance with atrioventricular concordance) prenatally evaluated in our referral center between 1998 and 2014 were included. Fetuses with additional congenital anomalies and those with incomplete follow-up were excluded. Prenatal diagnostic accuracy and short-term survival were analyzed for the different types of TGA. Results: The TGA type was correctly ascertained prenatally in 93.3%. Most fetuses were diagnosed with simple TGA (62.7%). There were 6 discrepancies: 5 fetuses with simple TGA had postnatally TGA + ventricular septal defect (VSD; n = 3) or TGA + VSD + coarctation of the aorta (n = 2), and 1 fetus with TGA + VSD postnatally showed severe left ventricular outflow tract obstruction. The mortality rate was 6.6%; it was higher in complex versus simple forms (12.8 vs. 1.9%, p = 0.038), and in cases with intramural coronary artery versus those without (60 vs. 3.5%, p < 0.001). We found no relationship between the arrangement of the great arteries and coronary arterial abnormalities. Conclusions: Simple TGA has a better outcome than the complex forms. A discrepancy rate of 7% with potential influence on the prognosis of survival between the prenatal diagnosis of the TGA type and the definitive diagnosis was found.

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Valoración pronóstica del switch arterial en la transposición de grandes arterias

García-Hernández

Montero-Valladares

Martínez-López

et al. 2011

Anales de Pediatría

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Factores de riesgo de la corrección anatómica para la transposición de grandes arterias

Cited by 8 publications

References 23 publications

Is arterial switch operation possible with neonatology-focused intensive care unit modality

Is arterial switch operation possible with neonatology-focused intensive care unit modality

Transposition of the Great Arteries in Fetal Life: Accuracy of Diagnosis and Short-Term Outcome

Valoración pronóstica del switch arterial en la transposición de grandes arterias

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