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Journal of Cardiothoracic Surgery
Published in: Journal of Cardiothoracic Surgery 1/2019

Open Access 01-12-2019 | Ventricular Septal Defect | Research article

The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation

Published in: Journal of Cardiothoracic Surgery | Issue 1/2019

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Abstract

Background

The aim of this study was to determine if there was a difference between coronary reimplantation after neoaortic reconstruction and open coronary reimplantation technique in arterial switch operation (ASO).

Methods

A total of 236 patients who underwent ASO from March 1994 to August 2018 were enrolled in this study. Multivariate analysis was performed for postoperative early mortality. Patients were divided into the open coronary reimplantation and coronary reimplantation after neoaortic reconstruction groups. The 30-day mortality, intraoperative and postoperative coronary artery (CA) revisions, CA–related late morbidity and mortality, and early and late neoaortic valve regurgitations after ASO were compared between the two groups.

Results

Overall postoperative early mortality was 7.2% (17/236). Patients who underwent open coronary reimplantation had higher early mortality as compared with those who underwent coronary reimplantation after neoaortic reconstruction. Risk factors for postoperative early mortality from multivariate analysis were cardiopulmonary bypass time and open coronary reimplantation. There was a higher incidence of CA–related late mortality or morbidity in the open coronary reimplantation group. The open coronary reimplantation group had a higher incidence of intraoperative or postoperative CA revision. There were no differences in the incidence of mild or more neoaortic valve regurgitation at discharge or in the 5-year freedom from mild or more neoaortic valve regurgitation.

Conclusions

CA reimplantation after neoaortic reconstruction yields better results in mortality and intraoperative or postoperative CA–related problems in ASO without increasing postoperative neoaortic valve regurgitation.
Literature
1.
Jatene AD, Fontes VF, Paulista PP, de Souza LC, Neger F, Galantier M, et al. Successful anatomic correction of transposition of the great vessels. A preliminary report. Arq Bras Cardiol. 1975;28(4):461–4.PubMed
2.
Pacifico AD, Stewart RW, Bargeron LM Jr. Repair of transposition of the great arteries with ventricular septal defect by an arterial switch operation. Circulation. 1983;68(3 Pt 2):II49–55.PubMed
3.
Bove EL. Current technique of the arterial switch procedure for transposition of the great arteries. J Card Surg. 1989;4(3):193–9.CrossRef
4.
Chang YH, Sung SC, Lee HD, Kim S, Woo JS, Lee YS. Coronary reimplantation after neoaortic reconstruction can yield better result in arterial switch operation: comparison with open trap door technique. Ann Thorac Surg. 2005;80(5):1634–40.CrossRef
5.
Yacoub MH, Radley-Smith R. Anatomy of the coronary arteries in transposition of the great arteries and methods for their transfer in anatomical correction. Thorax. 1978;33(4):418–24.CrossRef
6.
Brawn WJ, Mee RB. Early results for anatomic correction of transposition of the great arteries and for double-outlet right ventricle with subpulmonary ventricular septal defect. J Thorac Cardiovasc Surg. 1988;95(2):230–8.PubMed
7.
Anderson BR, Ciarleglio AJ, Hayes DA, Quaegebeur JM, Vincent JA, Bacha EA. Earlier arterial switch operation improves outcomes and reduces costs for neonates with transposition of the great arteries. J Am Coll Cardiol. 2014;63(5):481–7.CrossRef
8.
Khairy P, Clair M, Fernandes SM, Blume ED, Powell AJ, Newburger JW, et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation. 2013;127(3):331–9.CrossRef
9.
Raisky O, Bergoend E, Agnoletti G, Ou P, Bonnet D, Sidi D, et al. Late coronary artery lesions after neonatal arterial switch operation: results of surgical coronary revascularization. Eur J Cardiothorac Surg. 2007;31(5):894–8.CrossRef
10.
Legendre A, Losay J, Touchot-Kone A, Serraf A, Belli E, Piot JD, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation. 2003;108(Suppl 1):II186–90.PubMed
11.
Saini AP, Wolfe LT, Millington KA, Myers JL, Clark JB. Occult coronary ostial obstruction late after arterial switch operation. J Card Surg. 2013;28(3):308–11.CrossRef
12.
Thrupp SF, Gentles TL, Kerr AR, Finucane K. Arterial switch operation: early and late outcome for intramural coronary arteries. Ann Thorac Surg. 2012;94(6):2084–90.CrossRef
13.
Villafane J, Lantin-Hermoso MR, Bhatt AB, Tweddell JS, Geva T, Nathan M, et al. D-transposition of the great arteries: the current era of the arterial switch operation. J Am Coll Cardiol. 2014;64(5):498–511.CrossRef
14.
Friedman KG, Rathod RH, Farias M, Graham D, Powell AJ, Fulton DR, et al. Resource utilization after introduction of a standardized clinical assessment and management plan. Congenit Heart Dis. 2010;5(4):374–81.CrossRef
15.
Delmo Walter EM, Huebler M, Alexi-Meshkishvili V, Sill B, Berger F, Hetzer R. Fate of the aortic valve following the arterial switch operation. J Card Surg. 2010;25(6):730–6.CrossRef
16.
Michalak KW, Moll JA, Moll M, Dryzek P, Moszura T, Kopala M, et al. The neoaortic root in children with transposition of the great arteries after an arterial switch operation. Eur J Cardiothorac Surg. 2013;43(6):1101–8.CrossRef
17.
Pretre R, Tamisier D, Bonhoeffer P, Mauriat P, Pouard P, Sidi D, et al. Results of the arterial switch operation in neonates with transposed great arteries. Lancet. 2001;357(9271):1826–30.CrossRef
18.
Formigari R, Toscano A, Giardini A, Gargiulo G, Di Donato R, Picchio FM, et al. Prevalence and predictors of neoaortic regurgitation after arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg. 2003;126(6):1753–9.CrossRef
19.
Hawkins JA, Kouretas PC, Holubkov R, Williams RV, Tani LY, Su JT, et al. Intermediate-term results of repair for aortic, neoaortic, and truncal valve insufficiency in children. J Thorac Cardiovasc Surg. 2007;133(5):1311–7.CrossRef
20.
Keane MG, Wiegers SE, Plappert T, Pochettino A, Bavaria JE, Sutton MG. Bicuspid aortic valves are associated with aortic dilatation out of proportion to coexistent valvular lesions. Circulation. 2000;102(19 Suppl 3):III35–9.PubMed
21.
McMahon CJ, Ravekes WJ, Smith EO, Denfield SW, Pignatelli RH, Altman CA, et al. Risk factors for neo-aortic root enlargement and aortic regurgitation following arterial switch operation. Pediatr Cardiol. 2004;25(4):329–35.CrossRef
22.
Co-Vu JG, Ginde S, Bartz PJ, Frommelt PC, Tweddell JS, Earing MG. Long-term outcomes of the neoaorta after arterial switch operation for transposition of the great arteries. Ann Thorac Surg. 2013;95(5):1654–9.CrossRef
Metadata
Title
The coronary reimplantation after neoaortic reconstruction technique can make a difference in arterial switch operation
Publication date
01-12-2019
Published in
Journal of Cardiothoracic Surgery / Issue 1/2019
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-019-0994-8

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