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The right age for the en-bloc rotation of the outflow tracts: a single-centre experience

Kreuzer, Michaela ; Sames-Dolzer, Eva ; Tulzer, Andreas ; Gierlinger, Gregor ; Mair, Roland ; Nawrozi, Mohammad-Paimann ; Mair, Rudolf

European journal of cardio-thoracic surgery, 2023-06, Vol.63 (6) [Periódico revisado por pares]

Germany: Oxford University Press

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  • Título:
    The right age for the en-bloc rotation of the outflow tracts: a single-centre experience
  • Autor: Kreuzer, Michaela ; Sames-Dolzer, Eva ; Tulzer, Andreas ; Gierlinger, Gregor ; Mair, Roland ; Nawrozi, Mohammad-Paimann ; Mair, Rudolf
  • Assuntos: Child ; Follow-Up Studies ; Heart Septal Defects, Ventricular - complications ; Heart Septal Defects, Ventricular - surgery ; Humans ; Infant ; Infant, Newborn ; Retrospective Studies ; Rotation ; Transposition of Great Vessels - surgery ; Treatment Outcome ; Ventricular Outflow Obstruction - surgery
  • É parte de: European journal of cardio-thoracic surgery, 2023-06, Vol.63 (6)
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: Abstract OBJECTIVES The en-bloc rotation of the outflow tracts (EBR) enables an anatomic correction of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction. The anatomical condition or previous palliative procedures may allow choosing an elective date for the anatomic correction. The aim of this study was to evaluate the optimal age for performing the EBR based on the largest series published so far. METHODS At the Children’s Heart Center Linz, the EBR was performed in 33 patients between 2003 and 2021. Median age at operation was 74 [interquartile range (IQR) 17–627] days. Twelve patients were newborns (≤28 days), 9 older than 369 days. These 2 groups were compared to the remaining patients each regarding peri- and postoperative data, complications, reinterventions and mortality. The median follow-up period was 5.4 (IQR 0.99–11.74) years. RESULTS In-hospital mortality was 6.1%. All-cause mortality was lower in patients younger than 369 days at the time of EBR (4.2% vs 44.4% in patients >369 days old, P = 0.013). In newborns, intensive care unit stay (median 18.5 days vs 8 days, P = 0.008) and in-hospital stay (median 29.5 days vs 15 days, P = 0.026) were significantly longer, the risk for postoperative AV block was higher (33.3 vs 0%, P = 0.012) than in patients who had been corrected anatomically after the neonatal period. CONCLUSIONS The results of this study suggest the deferral of the EBR to the post-newborn period. A significantly higher mortality rate in patients of older age at operation seems to recommend the anatomic correction during the first year of life. The en-bloc rotation of the outflow tracts (EBR) allows an anatomic correction of transposition of the great arteries (TGA) with ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO) and similar forms of double outlet right ventricle (DORV) [1–5].
  • Editor: Germany: Oxford University Press
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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