Transplantation-free survival after Norwood surgery for hypoplastic left heart syndrome with aortic atresia: A Swedish national cohort study
| Autor: | Katarina Hanséus, Mats Mellander, Milad El-Segaier, Torsten Malm, Annika Öhman, Aldina Pivodic, Boris Nilsson, Gunnar Bergman, Sven-Erik Sonesson, Annika Rydberg |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Improved survival Gestational Age Kaplan-Meier Estimate 030204 cardiovascular system & hematology Norwood Procedures National cohort Hypoplastic left heart syndrome 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors 030225 pediatrics Prenatal Diagnosis Hypoplastic Left Heart Syndrome Medicine Humans Aortic atresia Registries Proportional Hazards Models Retrospective Studies Sweden business.industry Proportional hazards model Infant Newborn Gestational age General Medicine medicine.disease Surgery Transplantation Survival Rate Pediatrics Perinatology and Child Health Cohort Heart Transplantation Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Cardiology in the young. 30(3) |
| ISSN: | 1467-1107 1047-9511 |
| Popis: | Background:Norwood surgery has been available in Sweden since 1993. In this national cohort study, we analysed transplantation-free survival after Norwood surgery for hypoplastic left heart syndrome with aortic atresia.Methods:Patients were identified from the complete national cohort of live-born with hypoplastic left heart syndrome/aortic atresia 1993–2010. Analysis of survival after surgery was performed using Cox proportional hazards models for the total cohort and for birth period and gender separately. Thirty-day mortality and inter-stage mortality were analysed. Patients were followed until September 2016.Results:The 1993–2010 cohort consisted of 208 live-born infants. Norwood surgery was performed in 121/208 (58%). The overall transplantation-free survival was 61/121 (50%). The survival was higher in the late period (10-year survival 63%) than in the early period (10-year survival 40%) (p = 0.010) and lower for female (10-year survival 34%) than for male patients (10-year survival 59%) (p = 0.002). Inter-stage mortality between stages I and II decreased from 23 to 8% (p = 0.008). For male patients, low birthweight in relation to gestational age was a factor associated with poor outcome.Conclusion:The survival after Norwood surgery for hypoplastic left heart syndrome/aortic atresia improved by era of surgery, mainly explained by improved survival between stages I and II. Female gender was a significant risk factor for death or transplantation. For male patients, there was an increased risk of death when birthweight was lower than expected in relation to gestational age. |
| Databáze: | OpenAIRE |
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