Survival After Single-Stage Repair of Truncus Arteriosus and Associated Defects.

Autor:	Goyal A; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri. Electronic address: agoyal1@cmh.edu., Knight J; Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia., Hasan M; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri., Rao H; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri., Thomas AS; Center for Epidemiology and Clinical Research, School of Public Health, University of Minnesota, Minneapolis, Minnesota., Sarvestani A; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri., St Louis J; Department of Surgery, Medical College of Georgia, Augusta, Georgia., Kochilas L; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia., Raghuveer G; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2024 Jan; Vol. 117 (1), pp. 153-160. Date of Electronic Publication: 2023 Jul 04.
DOI:	10.1016/j.athoracsur.2023.06.017
Abstrakt:	Background: The goal of this study was to describe in-hospital and long-term mortality after single-stage repair of truncus arteriosus communis (TAC) and explore factors associated with these outcomes. Methods: This was a cohort study of consecutive patients undergoing single-stage TAC repair between 1982 and 2011 reported to the Pediatric Cardiac Care Consortium registry. In-hospital mortality was obtained for the entire cohort from registry records. Long-term mortality was obtained for patients with available identifiers by matching with the National Death Index through 2020. Kaplan-Meier survival estimates were created for up to 30 years after discharge. Cox regression models estimated hazard ratios for the associations with potential risk factors. Results: A total of 647 patients (51% male) underwent single-stage TAC repair at a median age of 18 days; 53% had type I TAC, 13% had interrupted aortic arch, and 10% underwent concomitant truncal valve surgery. Of these, 486 (75%) patients survived to hospital discharge. After discharge, 215 patients had identifiers for tracking long-term outcomes; 30-year survival was 78%. Concomitant truncal valve surgery at the index procedure was associated with increased in-hospital and 30-year mortality. Concomitant interrupted aortic arch repair was not associated with increased in-hospital or 30-year mortality. Conclusions: Concomitant truncal valve surgery but not interrupted aortic arch was associated with higher in-hospital and long-term mortality. Careful consideration of the need and timing for truncal valve intervention may improve TAC outcomes. (Published by Elsevier Inc.)
Databáze:	MEDLINE
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