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Characteristics and operative outcomes for children undergoing repair of truncus arteriosus: A contemporary multicenter analysis.

Publication ,  Journal Article
Mastropietro, CW; Amula, V; Sassalos, P; Buckley, JR; Smerling, AJ; Iliopoulos, I; Riley, CM; Jennings, A; Cashen, K; Narasimhulu, SS ...
Published in: J Thorac Cardiovasc Surg
June 2019

OBJECTIVE: We sought to describe characteristics and operative outcomes of children who underwent repair of truncus arteriosus and identify risk factors for the occurrence of major adverse cardiac events (MACE) in the immediate postoperative period in a contemporary multicenter cohort. METHODS: We conducted a retrospective review of children who underwent repair of truncus arteriosus between 2009 and 2016 at 15 centers within the United States. Patients with associated interrupted or obstructed aortic arch were excluded. MACE was defined as the need for postoperative extracorporeal membrane oxygenation, cardiopulmonary resuscitation, or operative mortality. Risk factors for MACE were identified using multivariable logistic regression analysis and reported as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: We reviewed 216 patients. MACE occurred in 44 patients (20%) and did not vary significantly over time. Twenty-two patients (10%) received postoperative extracorporeal membrane oxygenation, 26 (12%) received cardiopulmonary resuscitation, and 15 (7%) suffered operative mortality. With multivariable logistic regression analysis (which included adjustment for center effect), factors independently associated with MACE were failure to diagnose truncus arteriosus before discharge from the nursery (OR, 3.1; 95% CI, 1.3-7.4), cardiopulmonary bypass duration >150 minutes (OR, 3.5; 95% CI, 1.5-8.5), and right ventricle-to-pulmonary artery conduit diameter >50 mm/m2 (OR, 4.7; 95% CI, 2.0-11.1). CONCLUSIONS: In a contemporary multicenter analysis, 20% of children who underwent repair of truncus arteriosus experienced MACE. Early diagnosis, shorter duration of cardiopulmonary bypass, and use of smaller diameter right ventricle-to-pulmonary artery conduits represent potentially modifiable factors that could decrease morbidity and mortality in this fragile patient population.

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Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

June 2019

Volume

157

Issue

6

Start / End Page

2386 / 2398.e4

Location

United States

Related Subject Headings

  • United States
  • Truncus Arteriosus
  • Treatment Outcome
  • Retrospective Studies
  • Respiratory System
  • Prenatal Diagnosis
  • Male
  • Infant, Newborn
  • Humans
  • Cardiac Surgical Procedures
 

Citation

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Mastropietro, C. W., Amula, V., Sassalos, P., Buckley, J. R., Smerling, A. J., Iliopoulos, I., … Collaborative Research in Pediatric Cardiac Intensive Care Investigators, . (2019). Characteristics and operative outcomes for children undergoing repair of truncus arteriosus: A contemporary multicenter analysis. J Thorac Cardiovasc Surg, 157(6), 2386-2398.e4. https://doi.org/10.1016/j.jtcvs.2018.12.115
Mastropietro, Christopher W., Venu Amula, Peter Sassalos, Jason R. Buckley, Arthur J. Smerling, Ilias Iliopoulos, Christine M. Riley, et al. “Characteristics and operative outcomes for children undergoing repair of truncus arteriosus: A contemporary multicenter analysis.J Thorac Cardiovasc Surg 157, no. 6 (June 2019): 2386-2398.e4. https://doi.org/10.1016/j.jtcvs.2018.12.115.
Mastropietro CW, Amula V, Sassalos P, Buckley JR, Smerling AJ, Iliopoulos I, et al. Characteristics and operative outcomes for children undergoing repair of truncus arteriosus: A contemporary multicenter analysis. J Thorac Cardiovasc Surg. 2019 Jun;157(6):2386-2398.e4.
Mastropietro, Christopher W., et al. “Characteristics and operative outcomes for children undergoing repair of truncus arteriosus: A contemporary multicenter analysis.J Thorac Cardiovasc Surg, vol. 157, no. 6, June 2019, pp. 2386-2398.e4. Pubmed, doi:10.1016/j.jtcvs.2018.12.115.
Mastropietro CW, Amula V, Sassalos P, Buckley JR, Smerling AJ, Iliopoulos I, Riley CM, Jennings A, Cashen K, Narasimhulu SS, Narayana Gowda KM, Bakar AM, Wilhelm M, Badheka A, Moser EAS, Costello JM, Collaborative Research in Pediatric Cardiac Intensive Care Investigators. Characteristics and operative outcomes for children undergoing repair of truncus arteriosus: A contemporary multicenter analysis. J Thorac Cardiovasc Surg. 2019 Jun;157(6):2386-2398.e4.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

June 2019

Volume

157

Issue

6

Start / End Page

2386 / 2398.e4

Location

United States

Related Subject Headings

  • United States
  • Truncus Arteriosus
  • Treatment Outcome
  • Retrospective Studies
  • Respiratory System
  • Prenatal Diagnosis
  • Male
  • Infant, Newborn
  • Humans
  • Cardiac Surgical Procedures