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Long‐Term Survival and Freedom From Coronary Artery Reintervention After Arterial Switch Operation for Transposition of the Great Arteries: A Population‐Based Nationwide Study

BACKGROUND: The aim of this study was to evaluate long‐term survival and freedom from coronary artery reintervention after the arterial switch operation (ASO). METHODS AND RESULTS: This single‐center nationwide retrospective study included consecutive children who underwent ASO between 1990 and 2016...

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Autores principales: Koubský, Karel, Gebauer, Roman, Tláskal, Tomáš, Matějka, Tomáš, Poruban, Rudolf, Jičínská, Denisa, Hučín, Bohumil, Janoušek, Jan, Chaloupecký, Václav
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403335/
https://www.ncbi.nlm.nih.gov/pubmed/34169727
http://dx.doi.org/10.1161/JAHA.120.020479
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author Koubský, Karel
Gebauer, Roman
Tláskal, Tomáš
Matějka, Tomáš
Poruban, Rudolf
Jičínská, Denisa
Hučín, Bohumil
Janoušek, Jan
Chaloupecký, Václav
author_facet Koubský, Karel
Gebauer, Roman
Tláskal, Tomáš
Matějka, Tomáš
Poruban, Rudolf
Jičínská, Denisa
Hučín, Bohumil
Janoušek, Jan
Chaloupecký, Václav
author_sort Koubský, Karel
collection PubMed
description BACKGROUND: The aim of this study was to evaluate long‐term survival and freedom from coronary artery reintervention after the arterial switch operation (ASO). METHODS AND RESULTS: This single‐center nationwide retrospective study included consecutive children who underwent ASO between 1990 and 2016 (n=605). Long‐term outcomes were obtained by cross‐mapping individual data with the National Death Registry and the National Registry of Cardiovascular Interventions for adults. A control group was randomly retrieved at a 1:10 ratio from the National Birth and Death Registries. Early mortality was 3.3% and late mortality was 1.7% during a median follow‐up of 10 (interquartile range, 5–16) years. The probability of overall survival at 20 years after ASO was 94.9% compared with 99.5% in the background population (hazard ratio [HR] 15.6; 95% CI, 8.9–27.5, P<0.001). Independent multivariable predictors of worse survival were an intramural coronary artery (HR, 5.2; 95% CI, 1.8–15.2, P=0.002) and period of ASO 1990 to 1999 (HR, 4.6; 95% CI, 1.5–13.6, P<0.001). Fourteen patients (2.3%) required 16 coronary artery reoperations. Freedom from coronary artery reintervention at 20 years after ASO was 96%. The only independent multivariable predictor associated with a higher hazard for coronary artery reintervention was an intramural coronary artery (HR, 33.9; 95% CI, 11.8–97.5, P<0.001). CONCLUSIONS: Long‐term survival after ASO is excellent. Coronary artery reinterventions are rare. An intramural coronary artery was an independent predictor associated with a higher risk for coronary artery reintervention and death, regardless of the surgical period.
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spelling pubmed-84033352021-09-03 Long‐Term Survival and Freedom From Coronary Artery Reintervention After Arterial Switch Operation for Transposition of the Great Arteries: A Population‐Based Nationwide Study Koubský, Karel Gebauer, Roman Tláskal, Tomáš Matějka, Tomáš Poruban, Rudolf Jičínská, Denisa Hučín, Bohumil Janoušek, Jan Chaloupecký, Václav J Am Heart Assoc Original Research BACKGROUND: The aim of this study was to evaluate long‐term survival and freedom from coronary artery reintervention after the arterial switch operation (ASO). METHODS AND RESULTS: This single‐center nationwide retrospective study included consecutive children who underwent ASO between 1990 and 2016 (n=605). Long‐term outcomes were obtained by cross‐mapping individual data with the National Death Registry and the National Registry of Cardiovascular Interventions for adults. A control group was randomly retrieved at a 1:10 ratio from the National Birth and Death Registries. Early mortality was 3.3% and late mortality was 1.7% during a median follow‐up of 10 (interquartile range, 5–16) years. The probability of overall survival at 20 years after ASO was 94.9% compared with 99.5% in the background population (hazard ratio [HR] 15.6; 95% CI, 8.9–27.5, P<0.001). Independent multivariable predictors of worse survival were an intramural coronary artery (HR, 5.2; 95% CI, 1.8–15.2, P=0.002) and period of ASO 1990 to 1999 (HR, 4.6; 95% CI, 1.5–13.6, P<0.001). Fourteen patients (2.3%) required 16 coronary artery reoperations. Freedom from coronary artery reintervention at 20 years after ASO was 96%. The only independent multivariable predictor associated with a higher hazard for coronary artery reintervention was an intramural coronary artery (HR, 33.9; 95% CI, 11.8–97.5, P<0.001). CONCLUSIONS: Long‐term survival after ASO is excellent. Coronary artery reinterventions are rare. An intramural coronary artery was an independent predictor associated with a higher risk for coronary artery reintervention and death, regardless of the surgical period. John Wiley and Sons Inc. 2021-06-25 /pmc/articles/PMC8403335/ /pubmed/34169727 http://dx.doi.org/10.1161/JAHA.120.020479 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Koubský, Karel
Gebauer, Roman
Tláskal, Tomáš
Matějka, Tomáš
Poruban, Rudolf
Jičínská, Denisa
Hučín, Bohumil
Janoušek, Jan
Chaloupecký, Václav
Long‐Term Survival and Freedom From Coronary Artery Reintervention After Arterial Switch Operation for Transposition of the Great Arteries: A Population‐Based Nationwide Study
title Long‐Term Survival and Freedom From Coronary Artery Reintervention After Arterial Switch Operation for Transposition of the Great Arteries: A Population‐Based Nationwide Study
title_full Long‐Term Survival and Freedom From Coronary Artery Reintervention After Arterial Switch Operation for Transposition of the Great Arteries: A Population‐Based Nationwide Study
title_fullStr Long‐Term Survival and Freedom From Coronary Artery Reintervention After Arterial Switch Operation for Transposition of the Great Arteries: A Population‐Based Nationwide Study
title_full_unstemmed Long‐Term Survival and Freedom From Coronary Artery Reintervention After Arterial Switch Operation for Transposition of the Great Arteries: A Population‐Based Nationwide Study
title_short Long‐Term Survival and Freedom From Coronary Artery Reintervention After Arterial Switch Operation for Transposition of the Great Arteries: A Population‐Based Nationwide Study
title_sort long‐term survival and freedom from coronary artery reintervention after arterial switch operation for transposition of the great arteries: a population‐based nationwide study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403335/
https://www.ncbi.nlm.nih.gov/pubmed/34169727
http://dx.doi.org/10.1161/JAHA.120.020479
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