Value of preoperative echocardiography for the diagnosis of coronary artery patterns in neonates with transposition of the great arteries

Autor: Bernard Debost, Caroline Martin-Bonnet, Sylvie Di Filippo, Cecile Leconte, Claire Bertail-Galoin, Mohamed Bakloul, Thomas Perouse-de-Montclos, Anne Moulin-Zinsch
Přispěvatelé: Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 - Faculté des sciences et technologies (UCBL FST), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CarMeN, laboratoire
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Time Factors
Databases
Factual
Coronary Vessel Anomalies
Transposition of Great Vessels
[SDV]Life Sciences [q-bio]
Arterial switch operation
030204 cardiovascular system & hematology
Risk Assessment
Anatomie coronaire
Transposition (music)
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Internal medicine
Coronary artery anomaly
medicine
Humans
Transposition of the great arteries
030212 general & internal medicine
Significant risk
Diagnostic Errors
Échocardiographie
Adverse effect
Retrospective Studies
business.industry
Infant
Newborn
Reproducibility of Results
General Medicine
Perioperative
medicine.disease
Progression-Free Survival
3. Good health
[SDV] Life Sciences [q-bio]
Coronary arteries
medicine.anatomical_structure
Echocardiography
Great arteries
Switch artériel
Cardiology
Cardiology and Cardiovascular Medicine
business
Transposition des gros vaisseaux
Coronary pattern
Artery
Zdroj: Archives of cardiovascular diseases
Archives of cardiovascular diseases, 2021, 114 (2), pp.115-121. ⟨10.1016/j.acvd.2020.06.005⟩
Archives of cardiovascular diseases, Elsevier/French Society of Cardiology, 2021, 114 (2), pp.115-121. ⟨10.1016/j.acvd.2020.06.005⟩
ISSN: 1875-2136
1875-2128
DOI: 10.1016/j.acvd.2020.06.005
Popis: Summary Background Abnormal coronary pattern may complicate coronary transfer during arterial switch operation. Objective To evaluate the accuracy of echocardiography in assessing the anatomy of coronary arteries in neonates with transposition of the great arteries, and determine impact on outcomes. Methods We conducted a retrospective analysis of data in neonates with transposition of the great arteries. Preoperative echocardiographic coronary artery pattern and surgical intraoperative reports were compared. Mismatch between transthoracic echocardiography and surgical intraoperative reports and the impact on perioperative outcome were assessed. Coronary patterns were classified into four groups: type 1 (normal); type 2 (risk of coronary with intramural course); type 3 (coronary loop); and type 2 + 3. Results Overall, 108 neonates who underwent an arterial switch operation were included: 68 were classified as type 1; seven as type 2; 32 as type 3; and one as type 2 + 3. Overall, 10 adverse events occurred. Five patients died, three from coronary causes. Survival was 96% at 1 month. Transthoracic echocardiography and surgical intraoperative reports differed in 17.6% of cases. Mortality was 15.8% in case of inappropriate diagnosis and 2.2% for appropriate diagnosis (P = 0.01). Mortality in type 2 was 66.7% in case of discordance versus 0% when concordant. Multivariable analysis found that inappropriate preoperative transthoracic echocardiography diagnosis of coronary pattern was the only significant risk factor for mortality (P = 0.04). Conclusions Echocardiography can assess coronary artery anatomy in neonates with transposition of the great arteries. Intramural coronary course is often misdiagnosed. Preoperative misdiagnosis of coronary artery anomaly may impact perioperative mortality. However, this assessment will have to be confirmed by further larger studies.
Databáze: OpenAIRE
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