Abstract
The aim of the study was to determine the most significant risk factors of the right ventricular outflow tract obstruction, pulmonary artery stenosis and its branches in the long-term period after the arterial switch operation.
Materials and methods. The analysis of the results of treatment of 248 patients with transposition of the great arteries who was underwent the arterial switch operation. The incidence of the right ventricular outflow tract obstruction, pulmonary artery stenosis in the long-term period. The model for predicting the risk of developing this complication was obtained, the method of multiple logistic regression was applied.
Results. The mathematical model for predicting the risk of developing the right ventricular outflow tract obstruction, pulmonary artery stenosis, which includes the following factors: pulmonary artery reconstruction with ksenopericardium (OR 505.657, p=0.001), diameter of the aortic valve (OR 1.636, p<0.001).
Conclusion. Statistically significant predictors were revealed and a mathematical model for predicting the
risk of the right ventricular outflow tract obstruction, pulmonary artery stenosis in the postoperative period
was obtained, which has a sufficient level of statistical significance and predictive ability.
References
- Boсkeria L.A., Kim A.I. Transposition of great vessels.
In: Children's Cardiac Surgery. Guide for physicians.
Moscow; 2016: 569–604 (in Russ.)
- Huber C., Mimic B., Oswal N., Sullivan I. Kostolny M.,
Elliott M. et al. Outcomes and re-interventions after
one-stage repair of transposition of great arteries and
aortic arch obstruction. Eur. J. Cardiothorac. Surg.
2011; 39: 213–20. DOI:10.1016/j.ejcts.2010.05.009
- Pocar M., Villa E., Degandt A., Mauriat P., Pouard P.,
Vouhé P.R. Long-term results after primary one-stage
repair of transposition of the great arteries and aortic
arch obstruction. J. Am. Coll. Cardiol. 2005; 46: 1331–8.
DOI:10.1016/j.jacc.2005.06.063
- Moene R.J., Oppenheimer-Dekker A., Bartelings M.M.
Anatomic obstruction of the right ventricular outflow
tract in transposition of the great arteries. Am. J. Cardiol.
1983; 51: 1701–4. DOI: 10.1016/0002-9149(83)90213-8
- Moene R.J., Ottenkamp J., Oppenheimer-Dekker A.,
Bartelings M.M. Transposition of the great arteries and
narrowing of the aortic arch. Emphasis on right ventricular
characteristics. Br. Heart J. 1985; 53: 58–63. DOI:
10.1136/hrt.53.1.58
- Bokenkamp R., Aguilar E., van der Palen R.L.,
Sojak V., Bruggemans E.F., Hruda J. et al. Reoperation
for right ventricular outflow tract obstruction after arterial
switch operation for transposition of the great arteries
and aortic arch obstruction. Eur. J. Cardiothorac.
Surg. 2016; 49 (5): e91-6. DOI: 10.1093/ ejcts/ezw026
- Boyadjiev K., Ho S.Y., Anderson R.H., Lincoln Ch.
The potential for subpulmonary obstruction in complete
transposition after the arterial switch procedure:
an anatomic study. Eur. J. Cardiothorac. Surg. 1990; 4:
214–8. DOI: 10.1016/1010-7940(90)90008-N
- Nogi S., McCrindle B.W., Boutin C., Williams W.G.,
Freedom R.M., Benson L.N. Fate of the neopulmonary
valve after the arterial switch operation in neonates.
J. Thorac. Cardiovasc. Surg. 1998; 115: 557–62. DOI:
10.1016/S0022-5223(98)70317-4
- Urban A.E., Brecher A.M. The arterial switch repair
and the obstructive right ventricular outflow tract: does
it matter? Thorac. Cardiovasc. Surg. 1991; 39 (Suppl.):
170–5. DOI: 10.1055/s-2007-1020013
- Williams W.G., Quaegebeur J.M., Kirklin J.W.,
Blackstone E.H. The Congenital Heart Surgeons
Society. Outflow obstruction after the arterial switch
operation: a multiinstitutional study. J. Thorac.
Cardiovasc. Surg. 1997; 114: 975–90. DOI:10.1016/S0022-5223(97)70012-6
About the authors
- Boсkeria Leo Antonovich, Aсademician of RAN and RAMS, Director; orcid.org/0000-0002-6180-2619;
-
Nefedova Inessa Evgen'evna, Cand. Med. Sc., Chief of Department; orcid.org/0000-0002-9221-051X;
-
Berishvili David Olegovich, Dr. Med. Sc., Chief of Department; orcid.org/0000-0001-7379-345X;
-
Lyazin Denis Vladimirovich, Researcher; orcid.org/0000-0002-3499-8281;
-
Stepanicheva Ol'ga Aleksandrovna, Anesthesiologist; orcid.org/0000-0002-3157-8660