Low Risk of Pulmonary Valve Implantation After a Policy of Transatrial Repair of Tetralogy of Fallot Delayed Beyond the Neonatal Period
| Autor: | Yves d'Udekem, Igor E. Konstantinov, Sarah A. Hope, John C. Galati, M. Cheung, Glenda J. Rolley, Christian P. Brizard, Robert G. Weintraub, Gavin R. Wheaton, Leeanne Grigg, J. Ramsay |
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| Rok vydání: | 2014 |
| Předmět: |
Surgical repair
medicine.medical_specialty Palliative care business.industry Hazard ratio Retrospective cohort study medicine.disease Sudden death Surgery Cardiac surgery medicine.anatomical_structure Pulmonary valve Internal medicine medicine Cardiology business Cardiology and Cardiovascular Medicine Tetralogy of Fallot |
| Zdroj: | Journal of the American College of Cardiology. 63(6):563-568 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2013.10.011 |
| Popis: | Objectives The study sought to evaluate the late outcomes of a policy of transatrial repair delayed beyond the neonatal period. Background Long-term outcomes of transatrial repair of tetralogy of Fallot are unknown. Methods The records of 675 consecutive patients undergoing a transatrial repair of tetralogy of Fallot between 1980 and 2005 were reviewed, their follow-up updated and survival confirmed from national death registries. One-third (220 of 675) had undergone previous palliation. Median age at repair was 2 years in the first 8 years, and 1 year from 1988 onward. A transannular incision was performed in 75% of cases and autologous pericardium was the material used to patch this incision in 92% of cases. Results There were 7 hospital deaths (1%). Eight patients died during follow-up (2 sudden unexpected and 6 noncardiac deaths). Mean follow-up was 11.7 ± 6.3 years. Twenty-five years' survival was 97% (95% confidence interval [CI]: 95% to 98%). Twenty-five years' freedom from implantation of a valved conduit was 84.6% (95% CI: 77.8% to 89.5%). By multivariable analysis, prior palliation and younger age at repair were predictive of implantation of a valved conduit (hazard ratio: 2.4, 95% CI: 1.3 to 4.6, p = 0.008; hazard ratio: 0.70, 95% CI: 0.50 to 0.96, p = 0.03, respectively). Conclusions During long-term follow-up, transatrial repair of tetralogy of Fallot was associated with a minimal risk of sudden death and low rate of reintervention for right ventricular dilation and residual outflow tract obstruction. |
| Databáze: | OpenAIRE |
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