Outcomes of truncus arteriosus repair and predictors of mortality

Hamzah, Mohammed; Othman, Hasan F.; Daphtary, Kshama; Komarlu, Rukmini; Aly, Hany

doi:10.1111/jocs.14730

Cited by 10 publications

(4 citation statements)

References 26 publications

(26 reference statements)

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“…DiGeorge syndrome is also a risk factor for both gastrostomy and tracheostomy after complete repair of tetralogy of Fallot (13). In a recent study recent study that utilized the National Inpatient Sample dataset, patients with DiGeorge syndrome undergoing truncus arteriosus repair had higher rates of gastrostomy and tracheostomy compared with those without DiGeorge syndrome (14). Our findings support the high burden of disease DiGeorge syndrome adds to patients with conotruncal heart defects.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Gastrostomy and Tracheostomy in Infants Undergoing Truncus Arteriosus Repair: Database Study Using the Pediatric Health Information System

Hook

Delany

Buckley

et al. 2023

Pediatric Critical Care Medicine

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OBJECTIVES: We sought to determine the prevalence of and factors associated with gastrostomy tube placement and tracheostomy in infants undergoing truncus arteriosus repair, and associations between these procedures and outcome. DESIGN: Retrospective cohort study. SETTING: Pediatric Health Information System database. PATIENTS: Infants less than 90 days old who underwent truncus arteriosus repair from 2004 to 2019. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Multivariable logistic regression models were used to identify factors associated with gastrostomy tube and tracheostomy placement and to identify associations between these procedures and hospital mortality and prolonged postoperative length of stay (LOS; > 30 d). Of 1,645 subjects, gastrostomy tube was performed in 196 (11.9%) and tracheostomy in 56 (3.4%). Factors independently associated with gastrostomy tube placement were DiGeorge syndrome, congenital airway anomaly, admission age less than or equal to 2 days, vocal cord paralysis, cardiac catheterization, infection, and failure to thrive. Factors independently associated with tracheostomy congenital airway anomaly, truncal valve surgery, and cardiac catheterization. Gastrostomy tube was independently associated with prolonged postoperative LOS (odds ratio [OR], 12.10; 95% CI, 7.37–19.86). Hospital mortality occurred in 17 of 56 patients (30.4%) who underwent tracheostomy versus 147 of 1,589 patients (9.3%) who did not (p < 0.001), and median postoperative LOS was 148 days in patients who underwent tracheostomy versus 18 days in those who did not (p < 0.001). Tracheostomy was independently associated with mortality (OR, 3.11; 95% CI, 1.43–6.77) and prolonged postoperative LOS (OR, 9.85; 95% CI, 2.16–44.80). CONCLUSIONS: In infants undergoing truncus arteriosus repair, tracheostomy is associated with greater odds of mortality; while gastrostomy and tracheostomy are strongly associated with greater odds of prolonged postoperative LOS.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Gastrostomy and Tracheostomy in Infants Undergoing Truncus Arteriosus Repair: Database Study Using the Pediatric Health Information System

Hook

Delany

Buckley

et al. 2023

Pediatric Critical Care Medicine

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“…In aggregate, these 15 articles collectively represented 4,999 patients, with a slight male predominance at 54%. Notably, one study reported the largest cohort with 3,009 patients 37 .…”

Section: Study Selectionmentioning

confidence: 99%

A Contemporary Meta-analysis on Sex Differences in Surgical Mortality and Neurodevelopment in Congenital Heart Defects.

Crain,

Lim,

Sarfatis

et al. 2024

Preprint

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Need and purpose of review Given the increasing survival rates among congenital heart disease (CHD) patients and increasing awareness in sex-related disparities in CHD, there is a need to assess the impact of surgical interventions on neurodevelopmental outcomes and to explore potential differences in surgical mortality and neurodevelopmental outcomes between male and female patients. Methods In this systematic review, we adhered to PRISMA guidelines and PROSPERO registration. We searched articles published from 2015 to 2021 using MeSH descriptors in three major databases. Study selection criteria focused on pediatric CHD patients undergoing primary cardiac surgery. We reviewed 163 articles that met inclusion criteria. The definition and assessment of neurodevelopmental impairment, data extraction, risk of bias assessment, and statistical analysis methods were adhered by blinded reviewers. Main conclusions Previous studies have reported higher rates of early childhood mortality in female patients and higher rates of neurodevelopmental impairment in male patients with CHD requiring surgery. Our meta-analysis suggests that these differences may no longer be valid in contemporary surgical cohorts. It is unclear if sex-related risk factors have truly been mitigated with current surgical and medical approaches. Our meta-analysis does underscore the need for further research considering sex and investigating neurodevelopmental outcomes.

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“…The incidence of non-cardiac complications was also greater. Hamzah and colleagues reported a postsurgical mortality rate from 6.9 to 11% [ 76 , 77 , 78 ]. Particularly, the authors highlighted significant in-hospital mortality (more than 10% of cases).…”

Section: Outcome Of Cardiac Surgery In 22q112 Deletion Syndromementioning

confidence: 99%

22q11.2 Deletion Syndrome: Impact of Genetics in the Treatment of Conotruncal Heart Defects

et al. 2022

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Congenital heart diseases represent one of the hallmarks of 22q11.2 deletion syndrome. In particular, conotruncal heart defects are the most frequent cardiac malformations and are often associated with other specific additional cardiovascular anomalies. These findings, together with extracardiac manifestations, may affect perioperative management and influence clinical and surgical outcome. Over the past decades, advances in genetic and clinical diagnosis and surgical treatment have led to increased survival of these patients and to progressive improvements in postoperative outcome. Several studies have investigated long-term follow-up and results of cardiac surgery in this syndrome. The aim of our review is to examine the current literature data regarding cardiac outcome and surgical prognosis of patients with 22q11.2 deletion syndrome. We thoroughly evaluate the most frequent conotruncal heart defects associated with this syndrome, such as tetralogy of Fallot, pulmonary atresia with major aortopulmonary collateral arteries, aortic arch interruption, and truncus arteriosus, highlighting the impact of genetic aspects, comorbidities, and anatomical features on cardiac surgical treatment.

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Outcomes of truncus arteriosus repair and predictors of mortality

Cited by 10 publications

References 26 publications

Outcomes of Gastrostomy and Tracheostomy in Infants Undergoing Truncus Arteriosus Repair: Database Study Using the Pediatric Health Information System

Outcomes of Gastrostomy and Tracheostomy in Infants Undergoing Truncus Arteriosus Repair: Database Study Using the Pediatric Health Information System

A Contemporary Meta-analysis on Sex Differences in Surgical Mortality and Neurodevelopment in Congenital Heart Defects.

22q11.2 Deletion Syndrome: Impact of Genetics in the Treatment of Conotruncal Heart Defects

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