Modified Closed Coronary Transfer is a Good Alternative to the Trap-Door Method During Arterial Switch Operation: a Retrospective Propensity-Matched Comparison

Dedemoğlu, Mehmet; Coşkun, Gültekin; Özdemir, Fatih; Yurdakök, Okan; Korun, Oktay; Çiçek, Murat; Biçer, Mehmet; Coşkun, Fi̇li̇z; Aydemir, Numan Ali; Şaşmazel, Ahmet

doi:10.21470/1678-9741-2019-0263

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…kapalı koroner transfer tekniği uyguladıkları grupta açık trap-door grubundaki hastalara göre daha kısa kros klemp ve ameliyat süresi bulmuşlardır. 19 Çalışmamızda da bu çalışmalardaki bulgulara benzer şekilde kapalı koroner transfer tekniği (Grup 2) uygulanan hastalarda açık trap-door tekniği (Grup 1) uygulanan hastalara göre kros klemp süresi, kardiyopulmoner baypas süresi, yoğun bakımda kalış süresi ve hastanede kalış süresi daha kısaydı.…”

Section: Discussionunclassified

“…18 Bundan başka önce neoaortik kök anastomozunun arka yarısını yapıp ardından koroner transferlerin yapıldığı modifiye kapalı koroner transfer metodu, neoaortik kapak hasarını önlemek için açık trap-door metoduna iyi bir alternatif olabilir. 19 Biz hastalarımızda Bove'nin kapalı koroner transfer tekniğinden farklı olarak, önce aort köküne koroner arter reimplantasyonlarını yaptık. Koroner transferleri tamamladıktan sonra neoaortik kök anastomozunu yaptık.…”

Section: Discussionunclassified

“…Hastaların 86'sı (%79,6) erkek, 22'si (%20,4) kız ve medyan yaş (Q 25 -Q 75 ) değerleri 13 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) gündü.…”

Section: Bulgularunclassified

“…Hastaların 7'sine (%6,5) aortik ark patolojisi eşlik etmekteydi. Hastaların ortalama Aristotle kompleksite skoru medyan 13 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)5) idi. Yetmiş (%64,8) hastaya açık transfer tekniği ile koroner transfer uygulanırken (Grup 1), 38 (%35,2) hastaya kapalı teknik uygulandı (Grup 2).…”

Section: Bulgularunclassified

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Comparison of the Results of Open Trap-Door Technique and Closed Coronary Transfer Technique in Arterial Switch Operations: A Retrospective Clinical Study

DOYURGAN¹,

AKDENİZ²,

Kılıç³

et al. 2022

Turkiye Klinikleri J Cardiovasc Sci

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Arteriyel switch operasyonlarında, koroner translokasyon işleminin doğru yapılması ameliyatın başarısını etkileyen en önemli ögedir. Bu çalışmada, koroner arterlerin transferi için kullanılan 2 farklı translokasyon tekniğinin sonuçlarını karşılaştırdık. Gereç ve Yöntemler: Aralık 2017-Mayıs 2022 tarihleri arasında ardışık 108 hastaya arteriyel switch ameliyatı yapıldı. Hastaların tanıları intakt ventriküler septumlu büyük arter transpozisyonu (BAT) (n=68), ventriküler septal defektli BAT (n=34) ve Taussig-Bing anomalisi (n=6) idi. Yedi hastada aortik arkus anomalisi eşlik ediyordu. Hastaların 70'ine açık trap-door tekniği ile koroner trasfer yapıldı (Grup=1); 38 hastada kapalı koroner transfer metodu uygulandı (Grup=2). Bulgular: Hastaların 86'sı erkek, 22'si kız, medyan yaşı 13 gün ve ortalama vücut ağırlığı 3,3 kg'dı. Gruplar arasında ameliyat esnasındaki vücut ağırlığı, büyük arter ilişkisi ve koroner anomali varlığı bakımından fark yoktu. Tüm hastalar genelinde erken mortalite %12 (n=13) idi. Yirmi altı (%24,1) hastada koroner arter anomalisi saptandı. Koroner arter anomalisi olan hastalarda olmayanlara göre mortalite daha yüksekti (p=0,006). Grup 1 ve Grup 2 arasında komplikasyon ve mortalite bakımından anlamlı fark yoktu. Grup 2'deki hastalarda kros klemp süresi (p=0,009), kardiyopulmoner baypas süresi (p=0,001), yoğun bakımda kalış süresi (p=0,01), hastanede kalış süresi (p=0,001) ve vazoaktif inotrop skoru (p<0,001) Grup 1'deki hastalardan anlamlı olarak daha düşüktü. Takipte Grup 1'de hafif neoaortik kapak yetersizliği oranı Grup 2'den yüksekti (p=0,046). Sonuç: Kapalı teknik daha kısa kros klemp ve kardiyopulmoner baypas zamanı, daha kısa yoğun bakımda ve hastanede kalış süresi, daha düşük vazoaktif inotrop skoru sağlar ve bu teknik postoperatif neoaortik kapak yetersizliği riskini azaltır. Anah tar Ke li me ler: Arteriyel switch ameliyatı; koroner damarlar; reimplantasyon; büyük damarların transpozisyonu ABS TRACT Objective: Correct coronary translocation is the most important factor affecting the success of the operation in arterial switch operations. In this study, we compared the results of 2 different translocation techniques used for the transfer of coronary arteries. Material and Methods: Arterial switch surgery was performed on 108 consecutive patients between December 2017 and May 2022. The diagnoses of the patients were transposition of the great arteries with intact ventricular septum (n=68), transposition of the great arteries with ventricular septal defect (n=34) and Taussig-Bing anomaly (n=6). Aortic arch anomaly was accompanied in 7 patients. Coronary transfer was performed with the open trap-door technique in 70 of the patients (Group=1); closed coronary transfer method was applied in 38 patients (Group=2).Results: Eighty-six of the patients were male, 22 were female, median age was 13 days and mean body weight was 3.3 kg. There was no difference between the groups in terms of operative body weight, great artery relationship and presence of coronary anomaly. Early mortality was 12% (n=13...

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Section: Discussionunclassified

“…Hastaların 86'sı (%79,6) erkek, 22'si (%20,4) kız ve medyan yaş (Q 25 -Q 75 ) değerleri 13 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) gündü.…”

Section: Bulgularunclassified

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Comparison of the Results of Open Trap-Door Technique and Closed Coronary Transfer Technique in Arterial Switch Operations: A Retrospective Clinical Study

DOYURGAN¹,

AKDENİZ²,

Kılıç³

et al. 2022

Turkiye Klinikleri J Cardiovasc Sci

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“…An arterial switch series of a reference center in Turkey reveals a mortality rate of 6.4%. [ 11 ] It is reported by experienced centers in the world that early mortality in ASOs has been reduced to below 5%. Risk factors for early mortality are reported to be body weight less than 2.5 kg, resection for left ventricular outflow obstruction, concomitant aortic arch obstruction, prolonged CPB time.…”

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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Coronary transfer in the arterial switch operation: the modified closed technique

Rao

Kundan

Seth

et al. 2021

Indian J Thorac Cardiovasc Surg

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Modified Closed Coronary Transfer is a Good Alternative to the Trap-Door Method During Arterial Switch Operation: a Retrospective Propensity-Matched Comparison

Cited by 4 publications

References 7 publications

Comparison of the Results of Open Trap-Door Technique and Closed Coronary Transfer Technique in Arterial Switch Operations: A Retrospective Clinical Study

Comparison of the Results of Open Trap-Door Technique and Closed Coronary Transfer Technique in Arterial Switch Operations: A Retrospective Clinical Study

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

Coronary transfer in the arterial switch operation: the modified closed technique

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