TY - JOUR
T1 - Transposition of the Great Arteries
T2 - Lessons Learned About Patterns of Practice and Outcomes From the Congenital Heart Surgery Database of the Society of Thoracic Surgeons
AU - Jacobs, Jeffrey Phillip
AU - Jacobs, Marshall Lewis
AU - Mavroudis, Constantine
AU - Chai, Paul Jubeong
AU - Tchervenkov, Christo I.
AU - Lacour-Gayet, Francois G.
AU - Walters, Henry
AU - Quintessenza, James Anthony
N1 - Funding Information:
The authors thank the Cardiac Kids of Florida Foundation ( http://www.cardiackidsfl.com/ ), a 501(c)3 nonprofit organization, for its support of this research. The Mission of the Cardiac Kids Foundation of Florida is to collaborate with the Congenital Heart Institute of Florida (CHIF) to (1) provide assistance to families with children with heart disease who are in need of medical treatment and supplies and (2) fund medical research, education, and charitable health care for children with heart disease through local charitable initiatives and life-saving mission trips, in order to improve cardiac conditions affecting children worldwide. Jeffrey P. Jacobs, MD, FACS, FACC, FCCP, is the medical director of CardioAccess Inc. The author(s) received no financial support for the research and/or authorship of this article.
PY - 2011/1
Y1 - 2011/1
N2 - The Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database contains data about 3258 patients with the diagnosis of transposition of the great arteries (TGA) who underwent surgery during the 4-year time interval from July 1, 2005 to June 30, 2009, inclusive. This cohort includes 2918 patients with concordant atrioventricular connections and discordant ventriculoarterial connections and 341 patients with congenitally corrected TGA (discordant atrioventricular connections and discordant ventriculoarterial connections). The 4 most common operations were the following: (1) arterial switch operation (ASO) for TGA with intact ventricular septum (n = 1196), (2) ASO with ventricular septal defect (VSD) repair for TGA with VSD (n = 420), (3) ASO with VSD repair and aortic arch repair for TGA with VSD and hypoplastic arch (n = 55), and (4) Rastelli operation for TGA with VSD and left ventricular outflow tract obstruction (n = 49). Detailed preoperative, intraoperative, and postoperative data were obtained about patients who underwent these 4 operations. Median age at surgery (days) was as follows: ASO: 6.0; ASO with VSD repair: 7.0; ASO with VSD repair and aortic arch repair: 7.0; and Rastelli: 309.0. Mean age at surgery (days) was as follows: ASO: 22.9; ASO with VSD repair: 24.8; ASO with VSD repair and aortic arch repair: 14.4; and Rastelli: 721.8. Discharge mortality was as follows: ASO: 2.2%; ASO with VSD repair: 5.5%; ASO with VSD repair and aortic arch repair: 7.3%; and Rastelli: 0%. Median length of stay (days) was as follows: ASO: 11.0; ASO with VSD repair: 11.0; ASO with VSD repair and aortic arch repair: 18.0; and Rastelli: 7.0. The sternum was left open in the following: ASO: 24.8%; ASO with VSD repair: 29.5%; ASO with VSD repair and aortic arch repair: 40.0%; and Rastelli: 6.1%. This review of data from the STS Congenital Heart Surgery Database allows for unique documentation of patterns of practice and outcomes. From this review, we learned that although surgery for TGA is often complex and may be associated with morbidity, most patients survive without major complications.
AB - The Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database contains data about 3258 patients with the diagnosis of transposition of the great arteries (TGA) who underwent surgery during the 4-year time interval from July 1, 2005 to June 30, 2009, inclusive. This cohort includes 2918 patients with concordant atrioventricular connections and discordant ventriculoarterial connections and 341 patients with congenitally corrected TGA (discordant atrioventricular connections and discordant ventriculoarterial connections). The 4 most common operations were the following: (1) arterial switch operation (ASO) for TGA with intact ventricular septum (n = 1196), (2) ASO with ventricular septal defect (VSD) repair for TGA with VSD (n = 420), (3) ASO with VSD repair and aortic arch repair for TGA with VSD and hypoplastic arch (n = 55), and (4) Rastelli operation for TGA with VSD and left ventricular outflow tract obstruction (n = 49). Detailed preoperative, intraoperative, and postoperative data were obtained about patients who underwent these 4 operations. Median age at surgery (days) was as follows: ASO: 6.0; ASO with VSD repair: 7.0; ASO with VSD repair and aortic arch repair: 7.0; and Rastelli: 309.0. Mean age at surgery (days) was as follows: ASO: 22.9; ASO with VSD repair: 24.8; ASO with VSD repair and aortic arch repair: 14.4; and Rastelli: 721.8. Discharge mortality was as follows: ASO: 2.2%; ASO with VSD repair: 5.5%; ASO with VSD repair and aortic arch repair: 7.3%; and Rastelli: 0%. Median length of stay (days) was as follows: ASO: 11.0; ASO with VSD repair: 11.0; ASO with VSD repair and aortic arch repair: 18.0; and Rastelli: 7.0. The sternum was left open in the following: ASO: 24.8%; ASO with VSD repair: 29.5%; ASO with VSD repair and aortic arch repair: 40.0%; and Rastelli: 6.1%. This review of data from the STS Congenital Heart Surgery Database allows for unique documentation of patterns of practice and outcomes. From this review, we learned that although surgery for TGA is often complex and may be associated with morbidity, most patients survive without major complications.
KW - Rastelli
KW - arterial switch
KW - atrial switch
KW - cardiac surgery
KW - congenital heart disease
KW - congenitally corrected transposition of the great arteries
KW - database
KW - double switch
KW - outcomes
KW - results of treatment
KW - transposition of the great arteries
UR - http://www.scopus.com/inward/record.url?scp=84990374887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84990374887&partnerID=8YFLogxK
U2 - 10.1177/2150135110381392
DO - 10.1177/2150135110381392
M3 - Review article
C2 - 23804929
AN - SCOPUS:84990374887
SN - 2150-1351
VL - 2
SP - 19
EP - 31
JO - World Journal for Pediatric and Congenital Heart Surgery
JF - World Journal for Pediatric and Congenital Heart Surgery
IS - 1
ER -