Impact of Coronary Artery Anatomy in Arterial Switch Procedure on Early Mortality and Morbidity

Altin, Hüsnü Fırat; Şengül, Fatma Sevinç; Yıldız, Okan; Tosun, Öykü; Öztürk, Erkut; Kyaruzi, Mugısha; Çine, Nihat; Güzeltaş, Alper; Yeniterzi, Mehmet; Bakır, İhsan

doi:10.1111/chd.12295

Cited by 9 publications

(3 citation statements)

References 28 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to other studies, we showed that patients with unusual CA pattern have significantly higher bypass time during the ASO compared to those with usual CA pattern [30]. Nevertheless, there were no serious adverse events postoperatively related to the CA pattern in our patients.…”

Section: Discussionsupporting

confidence: 90%

“…Furthermore, there was no difference in the short-term postoperative cardiac function between those with minor or major CM. In a recent study, Altin et al have suggested that patients with TGA and unusual CA pattern are more prone to ventricular dysfunction, however there was no significant difference in the hospital stay between the patients with usual or unusual CA pattern in the first 6 months post-operatively [30]. They reported that intramural course of coronary arteries and the single RCA were the only unusual CA patterns that have an operative risk factor.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Commissural Malalignment as a predictor of coronary artery abnormalities in patients with transposition of great arteries

Nasef

Alghamdi

Valls

et al. 2020

J Congenit Heart Dis

View full text Add to dashboard Cite

Background In patients with transposition of the great arteries (TGA), commissural malalignment (CM) between semilunar valves may be associated with abnormal coronary (CA) pattern. We intend to assess the degree of CM with incidence of unusual CA anatomy. Methods We proposed a ratio to measure the distance of both ends of the anterior facing sinuses of the pulmonary valve from the facing commissure of the aortic valve. We labeled it as D1 and D2 distance. A ratio (C ratio) of the smaller distance (either D1 or D2 whichever is shorter) over the sum of both D1 and D2 was taken (D1 or D2 whichever is shorter / D1 + D2). We related this ratio with the incidence of the unusual CA anatomy in D-TGA patients. Results We had a total of 158 patients. We defined the point beyond which the C-Ratio becomes significantly associated with abnormal coronary artery pattern, this represents the median effective level (EL50). The EL50 of the C-Ratio was found to be equal to 31% (0.31). The prediction revealed that the CA pattern would most probably be usual when there is a minor commissural malalignment (C-Ratio less than the EL50) and most probably be unusual when there is a major malalignment (C-Ratio is greater than the EL50). The sensitivity was 71% and the specificity 88% (p-value < 0.0001). Conclusions The C-Ratio helps to categorize the degree of CM as minor (less than 0.31) or major (more than 0.31). A higher C-Ratio predicts a higher incidence of unusual CA pattern.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 96%

Commissural Malalignment as a predictor of coronary artery abnormalities in patients with transposition of great arteries

Nasef

Alghamdi

Valls

et al. 2020

J Congenit Heart Dis

View full text Add to dashboard Cite

show abstract

“…Transposition of the great arteries (TGA) is one of the most common congenital heart diseases in the neonatal period and is an important cause of hospitalization of newborns in the pediatric cardiac intensive care unit (ICU) in the first 2 weeks of life. [1] The first option in TGA treatment is arterial switch operation (ASO). Prostaglandin E1 infusion or balloon atrial septostomy procedures may be applied preoperatively to prevent the adverse effects of hypoxemia during the period till the time of operation.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Variations in the Neutrophil/Lymphocyte Ratio on the Length of Postoperative ICU Stay in Cases Diagnosed with Transposition of the Great Arteries

Özcanoğlu¹

2022

GKDA Derg

View full text Add to dashboard Cite

In this context, the objective of this study is to investigate the effect of variations in the neutrophil/lymphocyte ratio on the length of post-operative intensive care unit (ICU) stay in cases that were diagnosed with transposition of the great arteries (TGA) and who subsequently underwent arterial switch operation (ASO). Methods: This study was conducted with newborns that were diagnosed with TGA, followed up in the pediatric cardiac ICU, and who underwent ASO between January 1, 2021 and December 31, 2021. Variations in neutrophil-lymphocyte ratio (NLR) were recorded before and after the operation (day 1, 2, and 3). The primary endpoint was deemed as the prolonged post-operative ICU stay. For the purposes of this study, a prolonged post-operative ICU stay (PCILOS) was defined as a post-operative ICU stay that falls within the 25 th percentile of the lengths of stay with the most extended durations. Results:The patient group comprised 45 patients. The median age of the patients was 3 (interquartile range [IQR] 2-7) days, and the median operation weight was 3000 (IQR 2800-3100) grams. Of the patients included in the study, 51% were male, and 49% were female. Median duration on a mechanical ventilator, the median length of ICU stay, and median length of hospital stay were 48 (IQR 24-96) hours, 6 (IQR 5-12) days, and 12 (IQR 10-16) days, respectively. PCILOS duration was determined Amaç: Büyük arterlerin transpozisyonu yenidoğanlarda siyanotik kalp hastalığının önemli nedenlerinden biridir ve yaşamın ilk dönemlerinde cerrahi olarak tedavi edilmelidir. Son dönemlerde nötrofil/lenfosit oranı konjenital kalp hastalarında mortalite ve morbidite öngörüsü şeklinde yeni bir belirteç olarak kullanılmaktadır. Bu çalışmada, arteryel switch operasyonu yapılan büyük arterlerin transpozisyonu tanılı olgularda nötrofil/lenfosit oranı değişikliklerinin yoğun bakımda kalış süresine etkisi araştırıldı. Yöntem: Çalışma 1 Ocak 2021-31 Aralık 2021 tarihleri arasında pediatrik kardiyak yoğun bakım ünitesinde izlenen ve arteryel switch operasyonu gerçekleştirilen büyük arterlerin transpozisyonu tanılı yenidoğanlar üzerinde yapıldı. Operasyon öncesi ve sonrası (birinci, ikinci, üçüncü gün) nötrofil/lenfosit oranı değişiklikleri kaydedildi. Primer sonlanım noktası uzun yoğun bakım ünitesi süresi (pediatrik kardiyak yoğun bakım ünitesinde kalış süresi, süre olarak en uzun yüzde 25'lik dilimde olması) olarak kaydedildi. Nötrofil/lenfosit oranı değişikliklerinin pediatrik kardiyak yoğun bakım ünitesinde kalış süresi üzerine etkileri incelendi. Bulgular: Çalışma döneminde 45 olgu mevcuttu. Medyan yaş 3 gün (IQR 2-7 gün) ve medyan operasyon ağırlığı 3000 gram (IQR 2800-3100) idi. Olguların %51'i erkek, %49'u kızdı. Medyan mekanik ventilatörde kalış süresi, yoğun bakımda kalış süresi ve hastanede kalış süreleri sırasıyla 48 saat (IQR 24-96 saat), 6 gün (IQR 5-12) ve 12 gün (IQR 10-16) idi. Pediatrik kardiyak yoğun bakım ünitesinde kalış süresi >8 gün olarak saptandı. Dört (%8,8) hasta erken dönemde kaybedildi. Preoperatif nötrofil/lenfo-

show abstract

Preoperative Diagnostic Evaluation

Deal

Hauck

Tsao

et al. 2023

Pediatric Cardiac Surgery

View full text Add to dashboard Cite

Impact of Coronary Artery Anatomy in Arterial Switch Procedure on Early Mortality and Morbidity

Abstract: Coronary artery pattern was not a predictor of mortality in early postoperative period. There may be an impact of unusual coronary artery pattern on the development of ventricular dysfunction as a cause of mortality.

Cited by 9 publications

References 28 publications

Commissural Malalignment as a predictor of coronary artery abnormalities in patients with transposition of great arteries

Commissural Malalignment as a predictor of coronary artery abnormalities in patients with transposition of great arteries

The Effect of Variations in the Neutrophil/Lymphocyte Ratio on the Length of Postoperative ICU Stay in Cases Diagnosed with Transposition of the Great Arteries

Preoperative Diagnostic Evaluation

Contact Info

Product

Resources

About