Impact of Coronary Artery Anatomy in Arterial Switch Operation: In-hospital and Post-discharge Outcomes

Wang, Shuyuan; Zeng, Qingyu; Zhang, Li; Lv, Qing; Xie, Mingxing

doi:10.1007/s11596-022-2591-7

Cited by 2 publications

(1 citation statement)

References 35 publications

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“…Unless there are obstetric indications, it is preferable to deliver at 39 to 40 weeks, and children delivered at term have better long-term neurodevelopmental outcomes [2]. A Longer CPB time is a risk factor for major morbidity, which has been con rmed in many studies [15,16].…”

Section: Discussionmentioning

confidence: 99%

Integrated Prenatal and Postnatal Management for Neonates with Transposition of the Great Arteries: Thirteen-Year Experience at A Single Center

lin,

Huang,

Xie

et al. 2023

Preprint

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Background Transposition of the great arteries (TGA) is the most common cyanotic congenital heart defect in neonates with low prenatal detection rate. This study sought to review the prenatal diagnosis, associated abnormalities, and mid-term postnatal outcomes of fetuses with TGA and investigate the integrated prenatal and postnatal management for TGA neonates. Methods Children born with prenatal diagnosis of TGA in Guangdong Provincial People’s Hospital from January 2009 to December 2022 were included in the study. The prenatal ultrasound data and neonatal records were reviewed to assess the accuracy of prenatal diagnosis. Univariate and multivariate logistic and Cox analyses were used to analyze the correlation between risk factors and prognosis of TGA patients. Results 134 fetuses with prenatal diagnosis of TGA were included in this study and assessed at a median follow-up of 1.57 years [interquartile range (IQR) 0.07–4.28]. The population originated from 40 cities in 10 provinces in China, with integrated antenatal and postnatal management rate reaching 94.0% (126/134) and a high accuracy rate (99.3%) of prenatal primary diagnosis. There were 3 (2.2%) postnatal deaths, 118 (88.1%) patients undergoing Arterial switch operation (ASO), 3 (2.2%) undergoing Restelli operations and 5 (3.7%) doing stage operations. Of 118 patients receiving ASO, the major morbidity occurred in 64 patients, with gestational ages at birth (OR = 0.953, 95% CI 0.910–0.991; P = 0.025) and cardiopulmonary bypass time (OR = 1.010, 95% CI 1.000-1.030; P = 0.038) as independent risk factors. 26.3 percent (n = 31) experienced right ventricular outflow tract obstruction (RVOTO) after surgery. Independent risk factors was aortic cross-clamping time (HR = 1.030, 95% CI 1.000-1.050; P = 0.017). Conclusion Premature infants is significantly associated with increased morbidity. Integrated prenatal and postnatal management is recommended for those with prenatal diagnosis of TGA.

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Section: Discussionmentioning

confidence: 99%

Integrated Prenatal and Postnatal Management for Neonates with Transposition of the Great Arteries: Thirteen-Year Experience at A Single Center

lin,

Huang,

Xie

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

Integrated prenatal and postnatal management for neonates with transposition of the great arteries: thirteen-year experience at a single center

Lin,

Huang,

Xie

et al. 2024

Ital J Pediatr

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Background Transposition of the great arteries (TGA) is the most common cyanotic congenital heart defect in neonates but with low prenatal detection rate. This study sought to review the prenatal diagnosis, associated abnormalities, and mid-term postnatal outcomes of fetuses with TGA and investigate the integrated prenatal and postnatal management for TGA neonates. Methods A total of 134 infants prenatally diagnosed with TGA in Guangdong Provincial People’s Hospital, China, from January 2009 to December 2022 were included in the study. The prenatal ultrasound data and neonatal records were reviewed to assess the accuracy of prenatal diagnosis. Univariate and multivariate logistic and Cox analyses were used to identify risk factors associated with prognosis in such individuals. Results The population originated from 40 cities in 10 provinces in China, with integrated antenatal and postnatal management rate reaching 94.0% (126/134) and a high accuracy rate (99.3%) of prenatal primary diagnosis. The median period of follow-up was 1.6 [interquartile range (IQR) 0.1–4.3] years. There were 3 (2.2%) postnatal deaths, 118 (88.1%) patients undergoing arterial switch operation (ASO), 3 (2.2%) undergoing Rastelli operations and 5 (3.7%) doing stage operations. Of 118 patients receiving ASO, the major morbidity occurred in 64 patients (54.2%), and right ventricular outflow tract obstruction (RVOTO) in 31 (26.3%). In the multivariate logistic analysis, gestational ages at birth (OR = 0.953, 95% CI 0.910–0.991; p = 0.025) and cardiopulmonary bypass (CPB) time (OR = 1.010, 95% CI 1.000–1.030; p = 0.038) were identified as independent risk factors associated with major morbidity. In the Cox multivariate analysis, aortic cross-clamping time (HR = 1.030, 95% CI 1.000–1.050; p = 0.017) was identified as independent risk factor associated with RVOTO. Conclusion Earlier gestational ages at birth and longer CPB time are significantly associated with increased morbidity. Integrated prenatal and postnatal management is recommended for patients with prenatal diagnosis of TGA.

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Impact of Coronary Artery Anatomy in Arterial Switch Operation: In-hospital and Post-discharge Outcomes

Cited by 2 publications

References 35 publications

Integrated Prenatal and Postnatal Management for Neonates with Transposition of the Great Arteries: Thirteen-Year Experience at A Single Center

Integrated Prenatal and Postnatal Management for Neonates with Transposition of the Great Arteries: Thirteen-Year Experience at A Single Center

Integrated prenatal and postnatal management for neonates with transposition of the great arteries: thirteen-year experience at a single center

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