Prediction of early pulmonary artery stenosis after arterial switch operation: The role of intraoperative transesophageal echocardiography
Journal
Cardiology
Journal Volume
109
Journal Issue
4
Pages
230-236
Date Issued
2008
Author(s)
Abstract
Objectives: To investigate prospectively the prediction of the neopulmonary stenosis (neo-PS) after arterial switch operation (ASO) for transposition of the great artery (TGA) with intraoperative transesophageal echocardiography (TEE). Methods: Infants with TGA undergoing the ASO were prospectively studied over 5 years. The neo-PS was defined when the peak flow velocity was over 3 m/s at the neo main pulmonary artery (neo-MPA) after ASO by TEE (TEEPS). Catheterization was performed if estimated peak neo-PS pressure gradient was over 40 mm Hg by transthoracic echocardiography. Balloon angioplasty was tried first and surgical reoperation was reserved for those with failed angioplasty. Results: In total 49 consecutive patients were enrolled into the cohort study. TEEPS was identified in 21 patients. For patients with TEEPS, freedom from reintervention was 28% at 1 year and 23% at 2 years. For patients without TEEPS, freedom from reintervention for PS was 92% at 1 year and 78% at 2 years. The time interval from ASO to reintervention was significantly shorter in patients with TEEPS than without TEEPS. Existence of TEEPS and non-Lecompte method were main risk factor for reintervention. Conclusion: The present study demonstrated that the application of intraoperative TEE for infants undergoing ASO is very helpful in predicting the development of early postoperative neo-PS. Copyright ? 2007 S. Karger AG.
SDGs
Other Subjects
artery catheterization; article; balloon dilatation; clinical article; clinical trial; controlled study; female; great vessels transposition; heart ventricle septum defect; human; infant; male; peak expiratory flow; percutaneous transluminal angioplasty; priority journal; pulmonary artery stenosis; risk factor; surgical technique; transesophageal echocardiography; Cardiac Surgical Procedures; Echocardiography, Transesophageal; Female; Heart Catheterization; Humans; Intraoperative Care; Male; Prospective Studies; Pulmonary Artery; Pulmonary Valve Stenosis; Transposition of Great Vessels; Treatment Outcome
Type
journal article