Trends in Outcomes among Patients Undergoing Arterial Switch Procedure for D-Transposition of Great Arteries from a Single Center: 2001-2012 Year_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GAOHua-wei ¹ ,  LIShou-jun ¹ , YANJun ¹ , SHENXiang-dong ¹ , HUSheng-shou ¹ , WANGXu ¹ , YANFu-xia ² , LIUJin-ping ³

1. Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases & Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, P. R. China;
2. Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases & Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, P. R. China;
3. Department of Extracorporeal Circulation, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases & Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, P. R. China;

Corresponding author：

LIShou-jun, Email: drlishoujunfw@163.com

Keywords：

D-Transposition of the great arteries; Arterial switch operation; Trends

DOI：

10.7507/1007-4848.20150162

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Objective To examine changes of in-hospitalization mortality for arterial switch operation (ASO) for the patients with D-transposition of the great arteries (TGA) in our hospital. Methods We retrospectively analyzed the clinical data of 473 consecutive TGA patients undergoing ASO to assess temporal trends of in-hospital mortality between 2001 and 2012 year. The patients in every 2 years were brought together into a group. By this way, all the patients were divided into 6 groups. In risk-adjusted analyses, mortality of each group between 2001 and 2012 year were compared within the 6 groups. Results Among all the patients, 29 in-hospital deaths occurred. Between 2001 and 2012 year, the prevalence of preoperative factors-including age (P=0.13), gender (P=0.94), height (P=0.29), weight (P=0.21), combined with pulmonary hypertension (P=0.59), training for left ventricle (P=0.14), and anatomy of coronary arteries (P=0.27) did not significantly change. Crude mortality significantly decreased during that period (17.4% in the first group vs. 4.1% in the sixth group, P<0.001). Adjusted mortality also significantly became better in the ten years (the sixth group vs. the first group, odds ratio 0.098, 95% confidence interval, 0.018-0.550，P=0.01). Conclusion Between 2001 and 2012 year, the prevalence of risk factors among TGA patients undergoing ASO remains unchanged, but the in-hospital mortality substantial decreases.

Citation： GAOHua-wei, LIShou-jun, YANJun, SHENXiang-dong, HUSheng-shou, WANGXu, YANFu-xia, LIUJin-ping. Trends in Outcomes among Patients Undergoing Arterial Switch Procedure for D-Transposition of Great Arteries from a Single Center: 2001-2012 Year. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(7): 638-641. doi: 10.7507/1007-4848.20150162 Copy

1.	Jatene AD, Fontes VF, Paulista PP, et al. Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg, 1976, 72(3):364-370.
2.	Villafane J, Lantin-Hermoso MR, Bhatt AB, 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.
3.	刘迎龙, 朱晓东, 于存涛, 等. 近十年我国小儿先天性心脏病外科治疗的进展. 中华胸心血管外科杂志, 2002, 18(6):321-324.
4.	Dodge-Khatami A, Mavroudis C, Mavroudis CD, et al. Past, present, and future of the arterial switch operation:historical review. Cardiol Young, 2012, 22(6):724-731.
5.	Rudra HS, Mavroudis C, Backer CL, et al. The arterial switch operation:25-year experience with 258 patients. Ann Thorac Surg, 2011, 92(5):1742-1746.
6.	Khairy P, Clair M, Fernandes SM, et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation, 2013, 127(3):331-339.
7.	De Praetere H, Vandesande J, Rega F, et al. 20 years of arterial switch operation for simple TGA. Acta Chir Belg, 2014, 114(2):92-98.
8.	Karamlou T, Jacobs ML, Pasquali S, et al. Surgeon and center volume influence on outcomes after arterial switch operation:analysis of the STS Congenital Heart Surgery Database. Ann Thorac Surg, 2014, 98(3):904-911.
9.	Oda S, Nakano T, Sugiura J, et al. Twenty-eight years' experience of arterial switch operation for transposition of the great arteries in a single institution. Eur J Cardiothorac Surg, 2012, 42(4):674-679.
10.	Qamar ZA, Goldberg CS, Devaney EJ, et al. Current risk factors and outcomes for the arterial switch operation. Ann Thorac Surg, 2007,84(3):871-879.
11.	Lalezari S, Bruggemans EF, Blom NA, et al. Thirty-year experience with the arterial switch operation. Ann Thorac Surg, 2011, 92(3):973-979.
12.	Thrupp SF, Gentles TL, Kerr AR, et al. Arterial switch operation:early and late outcome for intramural coronary arteries. Ann Thorac Surg, 2012, 94(6):2084-2090.
13.	Fricke TA, d'Udekem Y, Richardson M, et al. Outcomes of the arterial switch operation for transposition of the great arteries:25 years of experience. Ann Thorac Surg, 2012, 94(1):139-145.
14.	张雅娟, 胡盛寿, 李守军, 等. 影响动脉转位术手术死亡的危险因素分析. 中国胸心血管外科临床杂志, 2010, 17(2):109-113.
15.	徐志伟, 邢万红, 刘锦纷, 等. 影响大动脉转位术死亡率的危险因素分析. 中国胸心血管外科临床杂志, 2006, 13(3):141-144.
16.	Legendre A, Losay J, Touchot-Kone A, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation, 2003, 108(Suppl 1):Ⅱ 186-Ⅱ 190.
17.	Na KJ, Kim WH, Jang WS, et al. Unroofing intramural coronary artery for late coronary events after arterial switch operation. Ann Thorac Surg, 2014, 97(3):1062-1064.
18.	Suzuki T. Modification of the arterial switch operation for transposition of the great arteries with complex coronary artery patterns. Gen Thorac Cardiovasc Surg, 2009, 57(6):281-292.
19.	Martins P, Castela E. Transposition of the great arteries. Orphanet J Rare Dis, 2008, 3:27.
20.	Oztunc F, Baris S, Adaletli I, et al. Coronary events and anatomy after arterial switch operation for transposition of the great arteries:detection by 16-row multislice computed tomography angiography in pediatric patients. Cardiovasc Intervent Radiol, 2009, 32(2):206-212.

1. Jatene AD, Fontes VF, Paulista PP, et al. Anatomic correction of transposition of the great vessels. J Thorac Cardiovasc Surg, 1976, 72(3):364-370.
2. Villafane J, Lantin-Hermoso MR, Bhatt AB, 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.
3. 刘迎龙, 朱晓东, 于存涛, 等. 近十年我国小儿先天性心脏病外科治疗的进展. 中华胸心血管外科杂志, 2002, 18(6):321-324.
4. Dodge-Khatami A, Mavroudis C, Mavroudis CD, et al. Past, present, and future of the arterial switch operation:historical review. Cardiol Young, 2012, 22(6):724-731.
5. Rudra HS, Mavroudis C, Backer CL, et al. The arterial switch operation:25-year experience with 258 patients. Ann Thorac Surg, 2011, 92(5):1742-1746.
6. Khairy P, Clair M, Fernandes SM, et al. Cardiovascular outcomes after the arterial switch operation for D-transposition of the great arteries. Circulation, 2013, 127(3):331-339.
7. De Praetere H, Vandesande J, Rega F, et al. 20 years of arterial switch operation for simple TGA. Acta Chir Belg, 2014, 114(2):92-98.
8. Karamlou T, Jacobs ML, Pasquali S, et al. Surgeon and center volume influence on outcomes after arterial switch operation:analysis of the STS Congenital Heart Surgery Database. Ann Thorac Surg, 2014, 98(3):904-911.
9. Oda S, Nakano T, Sugiura J, et al. Twenty-eight years' experience of arterial switch operation for transposition of the great arteries in a single institution. Eur J Cardiothorac Surg, 2012, 42(4):674-679.
10. Qamar ZA, Goldberg CS, Devaney EJ, et al. Current risk factors and outcomes for the arterial switch operation. Ann Thorac Surg, 2007,84(3):871-879.
11. Lalezari S, Bruggemans EF, Blom NA, et al. Thirty-year experience with the arterial switch operation. Ann Thorac Surg, 2011, 92(3):973-979.
12. Thrupp SF, Gentles TL, Kerr AR, et al. Arterial switch operation:early and late outcome for intramural coronary arteries. Ann Thorac Surg, 2012, 94(6):2084-2090.
13. Fricke TA, d'Udekem Y, Richardson M, et al. Outcomes of the arterial switch operation for transposition of the great arteries:25 years of experience. Ann Thorac Surg, 2012, 94(1):139-145.
14. 张雅娟, 胡盛寿, 李守军, 等. 影响动脉转位术手术死亡的危险因素分析. 中国胸心血管外科临床杂志, 2010, 17(2):109-113.
15. 徐志伟, 邢万红, 刘锦纷, 等. 影响大动脉转位术死亡率的危险因素分析. 中国胸心血管外科临床杂志, 2006, 13(3):141-144.
16. Legendre A, Losay J, Touchot-Kone A, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation, 2003, 108(Suppl 1):Ⅱ 186-Ⅱ 190.
17. Na KJ, Kim WH, Jang WS, et al. Unroofing intramural coronary artery for late coronary events after arterial switch operation. Ann Thorac Surg, 2014, 97(3):1062-1064.
18. Suzuki T. Modification of the arterial switch operation for transposition of the great arteries with complex coronary artery patterns. Gen Thorac Cardiovasc Surg, 2009, 57(6):281-292.
19. Martins P, Castela E. Transposition of the great arteries. Orphanet J Rare Dis, 2008, 3:27.
20. Oztunc F, Baris S, Adaletli I, et al. Coronary events and anatomy after arterial switch operation for transposition of the great arteries:detection by 16-row multislice computed tomography angiography in pediatric patients. Cardiovasc Intervent Radiol, 2009, 32(2):206-212.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Trends in Outcomes among Patients Undergoing Arterial Switch Procedure for D-Transposition of Great Arteries from a Single Center: 2001-2012 Year

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