Utilization and Outcomes of the Nikaidoh, Rastelli, and REV Procedures: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database
| Autor: | Jeffery P. Jacobs, Mario Castro-Medina, Laura Seese, Kevin D. Hill, Melita Viegas, Dylan Thibault, Luciana Da Fonseca Da Silva, Harma K. Turbendian, Marshall L. Jacobs, Michael Shillingford, Jose Pedro da Silva, Victor O. Morell |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Heart Defects Congenital Heart Septal Defects Ventricular congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Aortic root Transposition of Great Vessels Ventricular outflow tract obstruction computer.software_genre law.invention Ventricular Outflow Obstruction law Double outlet right ventricle Interquartile range Cardiopulmonary bypass Medicine Humans Retrospective Studies Surgeons Database business.industry Infant Retrospective cohort study medicine.disease Double Outlet Right Ventricle Surgery Cardiac operations Treatment Outcome Great arteries medicine.symptom Cardiology and Cardiovascular Medicine business computer |
| Zdroj: | The Annals of thoracic surgery. 114(3) |
| ISSN: | 1552-6259 |
| Popis: | Aortic root translocation (Nikaidoh), Rastelli, and réparation à l'etage ventriculaire (REV) are repair options for transposition of the great arteries (TGA) with ventricular septal defects and left ventricular outflow tract obstruction (VSD-LVOTO) or double outlet right ventricle TGA type (DORV-TGA).This retrospective study using The Society of Thoracic Surgeons Congenital Heart Surgery Database evaluates surgical procedure utilization and outcomes of patients undergoing repair of TGA-VSD-LVOTO and DORV-TGA with a Nikaidoh, Rastelli, or REV procedure.A total of 293 patients underwent repair at 82 centers (January 2010 to June 2019). Most patients underwent a Rastelli (n = 165, 56.3%) or a Nikaidoh (n = 119, 40.6%) operation; only 3.1% (n = 9) underwent a REV. High-volume centers performed the majority of the repairs. Fewer Nikaidoh than Rastelli patients had prior cardiac operations (n = 57 [48.7%] vs n = 102 [63.0%]; P = .004). Nikaidohs had longer median cardiopulmonary bypass time (227 [interquartile range (IQR), 167-299] minutes vs 175 [IQR, 133-225] minutes; P.001) and median aortic cross-clamp times (131 [IQR, 91-175] minutes vs 105 [IQR, 82-141] minutes; P = .0015). Operative mortality was 3.1% (95% confidence interval [CI], 1.0%-7.0%; n = 5) for Rastelli, 4.4% (95% CI, 1.4%-9.9%; n = 5) for Nikaidoh, and 11.1% (95% CI, 0.3%-48.3%, n = 1) for REV. The rates of cardiac arrest, unplanned reoperation, mechanical circulatory support, prolonged ventilation, and permanent pacemaker placement were higher in the Nikaidoh population but with 95% CIs overlapping those of the other procedures.Rastelli and Nikaidoh procedures are the prevalent repair strategies for patients with DORV-TGA and TGA-VSD-LVOTO. Most are performed at high-volume institutions, and early outcomes are similar. |
| Databáze: | OpenAIRE |
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