Abstract | OBJECTIVE: METHODS: RESULTS: Data from 549 subjects (follow-up, 2.7 ± 0.9 years) were analyzed. Mortality risk was characterized by early and constant phases; transplant was characterized by only a constant phase. Early phase factors associated with death included lower socioeconomic status (P = .01), obstructed pulmonary venous return (P < .001), smaller ascending aorta (P = .02), and anatomic subtype. Constant phase factors associated with death included genetic syndrome (P < .001) and lower gestational age (P < .001). The right ventricle-to-pulmonary artery shunt demonstrated better survival in the 51% of subjects who were full term with aortic atresia (P < .001). The modified Blalock-Taussig shunt was better among the 4% of subjects who were preterm with a patent aortic valve (P = .003). Lower pre-Norwood right ventricular fractional area change, pre-Norwood surgery, and anatomy other than hypoplastic left heart syndrome were independently associated with transplantation (all P < .03), but shunt type was not (P = .43). CONCLUSIONS: Independent risk factors for intermediate-term mortality include lower socioeconomic status, anatomy, genetic syndrome, and lower gestational age. Term infants with aortic atresia benefited from a right ventricle-to-pulmonary artery shunt, and preterm infants with a patent aortic valve benefited from a modified Blalock-Taussig shunt. Right ventricular function and anatomy, but not shunt type, were associated with transplantation.
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Authors | James S Tweddell, Lynn A Sleeper, Richard G Ohye, Ismee A Williams, Lynn Mahony, Christian Pizarro, Victoria L Pemberton, Peter C Frommelt, Scott M Bradley, James F Cnota, Jennifer Hirsch, Paul M Kirshbom, Jennifer S Li, Nancy Pike, Michael Puchalski, Chitra Ravishankar, Jeffrey P Jacobs, Peter C Laussen, Brian W McCrindle, Pediatric Heart Network Investigators |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 144
Issue 1
Pg. 152-9
(Jul 2012)
ISSN: 1097-685X [Electronic] United States |
PMID | 22341427
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Copyright | Copyright © 2012 The American Association for Thoracic Surgery. All rights reserved. |
Topics |
- Algorithms
- Blalock-Taussig Procedure
(mortality)
- Child, Preschool
- Echocardiography, Doppler
- Female
- Gestational Age
- Heart Transplantation
(mortality)
- Humans
- Hypoplastic Left Heart Syndrome
(diagnostic imaging, mortality, surgery)
- Infant
- Infant, Newborn
- Infant, Premature
- Male
- Norwood Procedures
(mortality)
- Risk Factors
- Social Class
- Treatment Outcome
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