Author(s):
Sarris, G 
; Chatzis, A ; Giannopoulos, N ; Kirvassilis, G ; Berggren, H ; Hazekamp, M ; Carrel, T ; Comas, J ; Carlo, D ; Daenen, W ; Ebels, T ; Fragata, J ; Hraska, V ; Ilyin, V ; Lindberg, H ; Metras, D ; Pozzi, M ; Rubay, J ; Sairanen, H ; Stellin, G ; Urban, A ; Doorn, C ; Ziemer, G
Date: 2006
Persistent ID: http://hdl.handle.net/10400.17/416
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): Europa; Análise Multivariada; Estudos Retrospectivos; Transposição dos Grandes Vasos; Procedimentos Cirúrgicos Vasculares
Description
OBJECTIVES: This study analyzes the results of the arterial switch operation for transposition of the great arteries in member institutions of the European Congenital Heart Surgeons Association.
METHODS: The records of 613 patients who underwent primary arterial switch operations in each of 19 participating institutions in the period from January 1998 through December 2000 were reviewed retrospectively.
RESULTS: A ventricular septal defect was present in 186 (30%) patients. Coronary anatomy was type A in 69% of the patients, and aortic arch pathology was present in 20% of patients with ventricular septal defect. Rashkind septostomy was performed in 75% of the patients, and 69% received prostaglandin. There were 37 hospital deaths (operative mortality, 6%), 13 (3%) for patients with an intact ventricular septum and 24 (13%) for those with a ventricular septal defect (P < .001). In 36% delayed sternal closure was performed, 8% required peritoneal dialysis, and 2% required mechanical circulatory support. Median ventilation time was 58 hours, and intensive care and hospital stay were 6 and 14 days, respectively. Although of various preoperative risk factors the presence of a ventricular septal defect, arch pathology, and coronary anomalies were univariate predictors of operative mortality, only the presence of a ventricular septal defect approached statistical significance (P = .06) on multivariable analysis. Of various operative parameters, aortic crossclamp time and delayed sternal closure were also univariate predictors; however, only the latter was an independent statistically significant predictor of death.
CONCLUSIONS: Results of the procedure in European centers are compatible with those in the literature. The presence of a ventricular septal defect is the clinically most important preoperative risk factor for operative death, approaching statistical significance on multivariable analysis.
