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Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis.

Publication ,  Journal Article
Pasquali, SK; Hasselblad, V; Li, JS; Kong, DF; Sanders, SP
Published in: Circulation
November 12, 2002

BACKGROUND: Prior studies of coronary pattern and outcome after arterial switch operation (ASO) for transposition of the great arteries (TGA) have been hindered by limited statistical power. This meta-analysis assesses the effect of coronary anatomy on post-ASO mortality, both overall and adjusted for time. METHODS AND RESULTS: A literature search revealed 9 independent series that reported post-ASO mortality by coronary pattern in a total of 1942 patients. Odds ratios comparing all-cause mortality in patients with usual versus variant coronary patterns were calculated and combined by use of an empirical Bayesian model. Single coronary patterns, both of which loop around the great vessels, were associated with significant mortality (OR 2.9, 95% CI 1.3 to 6.8), whereas looping patterns that arose from 2 separate ostia were not (OR 1.2, 95% CI 0.8 to 1.9). This latter group includes patients with the most common variant, circumflex from right coronary artery. Patients with an intramural coronary artery had the greatest mortality (OR 6.5, 95% CI 2.9 to 14.2). Overall, patients with any variant coronary pattern had nearly twice the mortality seen in those with the usual pattern (OR 1.7, 95% CI 1.3 to 2.4). Single ostium patterns and intramural coronary arteries remained associated with significant added mortality after adjustment for time-trend effects. CONCLUSIONS: Over the past 2 decades, patients with common coronary variants have undergone ASO without added mortality compared with those with the usual coronary pattern. Those with intramural or single coronary arteries have significant added mortality that has persisted over time.

Duke Scholars

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

November 12, 2002

Volume

106

Issue

20

Start / End Page

2575 / 2580

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transposition of Great Vessels
  • Time Factors
  • Odds Ratio
  • Infant, Newborn
  • Humans
  • Coronary Vessel Anomalies
  • Cardiovascular System & Hematology
  • 4207 Sports science and exercise
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Pasquali, S. K., Hasselblad, V., Li, J. S., Kong, D. F., & Sanders, S. P. (2002). Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation, 106(20), 2575–2580. https://doi.org/10.1161/01.cir.0000036745.19310.bb
Pasquali, Sara K., Vic Hasselblad, Jennifer S. Li, David F. Kong, and Stephen P. Sanders. “Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis.Circulation 106, no. 20 (November 12, 2002): 2575–80. https://doi.org/10.1161/01.cir.0000036745.19310.bb.
Pasquali SK, Hasselblad V, Li JS, Kong DF, Sanders SP. Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation. 2002 Nov 12;106(20):2575–80.
Pasquali, Sara K., et al. “Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis.Circulation, vol. 106, no. 20, Nov. 2002, pp. 2575–80. Pubmed, doi:10.1161/01.cir.0000036745.19310.bb.
Pasquali SK, Hasselblad V, Li JS, Kong DF, Sanders SP. Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation. 2002 Nov 12;106(20):2575–2580.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

November 12, 2002

Volume

106

Issue

20

Start / End Page

2575 / 2580

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transposition of Great Vessels
  • Time Factors
  • Odds Ratio
  • Infant, Newborn
  • Humans
  • Coronary Vessel Anomalies
  • Cardiovascular System & Hematology
  • 4207 Sports science and exercise
  • 3202 Clinical sciences