Growth Pattern of the Neo-Aorta after Arterial Switch Operation during Childhood.
Aorta
Arterial switch operation
Dilatation
Journal
Korean circulation journal
ISSN: 1738-5520
Titre abrégé: Korean Circ J
Pays: Korea (South)
ID NLM: 101247141
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
08
06
2020
revised:
15
09
2020
accepted:
24
09
2020
pubmed:
10
11
2020
medline:
10
11
2020
entrez:
9
11
2020
Statut:
ppublish
Résumé
Neo-aortic root dilatation (ARD) and annular dilatation (AAD) tend to develop after arterial switch operation (ASO). However, the trend of neo-aortic growth has not been well established. This paper aims to identify this trend, its associated factors, and predictors of neo-aortic dilatation after ASO. We analyzed the growth trend of the neo-aortic root, annulus, and sinotubular junction (STJ) z-scores using random coefficients model and the risk factors affecting neo-aortic dilatation in 163 patients who underwent ASO from 2006 to 2015. Among 163 patients, 41 had a ventricular septal defect, and 11 had Taussig-Bing (TB) anomaly. The median follow-up duration was 6.61 years. The increased in the neo-aortic root z-score was different between the trapdoor and non-trapdoor coronary artery transfer techniques (0.149/year, p<0.001 vs. 0.311/year, p<0.001). Moreover, the neo-aortic annulus and STJ z-score significantly increased over time after ASO (0.067/year, p<0.001; 0.309/year, p<0.001). Pulmonary artery banding (PAB) was rather a negative affecting factor. The probabilities of freedom from ARD, AAD, and neo-aortic STJ dilatation at 10 years after ASO were 33.4%, 53.9%, and 65.4%. Neo- aortic regurgitation within 1 year was the predictor of ARD, AAD, and neo-aortic STJ dilatation. TB anomaly, PAB, and native pulmonary sinus z-score were other predictors for ARD. The growth of neo-aortic root, annulus, and STJ after ASO was greater than somatic growth during childhood. The coronary artery transfer technique affected the growth pattern of the neo-aortic root.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Neo-aortic root dilatation (ARD) and annular dilatation (AAD) tend to develop after arterial switch operation (ASO). However, the trend of neo-aortic growth has not been well established. This paper aims to identify this trend, its associated factors, and predictors of neo-aortic dilatation after ASO.
METHODS
METHODS
We analyzed the growth trend of the neo-aortic root, annulus, and sinotubular junction (STJ) z-scores using random coefficients model and the risk factors affecting neo-aortic dilatation in 163 patients who underwent ASO from 2006 to 2015.
RESULTS
RESULTS
Among 163 patients, 41 had a ventricular septal defect, and 11 had Taussig-Bing (TB) anomaly. The median follow-up duration was 6.61 years. The increased in the neo-aortic root z-score was different between the trapdoor and non-trapdoor coronary artery transfer techniques (0.149/year, p<0.001 vs. 0.311/year, p<0.001). Moreover, the neo-aortic annulus and STJ z-score significantly increased over time after ASO (0.067/year, p<0.001; 0.309/year, p<0.001). Pulmonary artery banding (PAB) was rather a negative affecting factor. The probabilities of freedom from ARD, AAD, and neo-aortic STJ dilatation at 10 years after ASO were 33.4%, 53.9%, and 65.4%. Neo- aortic regurgitation within 1 year was the predictor of ARD, AAD, and neo-aortic STJ dilatation. TB anomaly, PAB, and native pulmonary sinus z-score were other predictors for ARD.
CONCLUSION
CONCLUSIONS
The growth of neo-aortic root, annulus, and STJ after ASO was greater than somatic growth during childhood. The coronary artery transfer technique affected the growth pattern of the neo-aortic root.
Identifiants
pubmed: 33164353
pii: 51.e3
doi: 10.4070/kcj.2020.0249
pmc: PMC7779819
doi:
Types de publication
Journal Article
Langues
eng
Pagination
83-93Informations de copyright
Copyright © 2021. The Korean Society of Cardiology.
Déclaration de conflit d'intérêts
The authors have no financial conflicts of interest.
Références
J Am Coll Cardiol. 2014 Aug 5;64(5):498-511
pubmed: 25082585
Ann Thorac Surg. 2008 Mar;85(3):823-30
pubmed: 18291150
Eur J Cardiothorac Surg. 2009 Apr;35(4):582-7; discussion 587-8
pubmed: 19223194
Eur J Cardiothorac Surg. 2006 Feb;29(2):162-7
pubmed: 16386434
J Am Coll Cardiol. 2006 May 16;47(10):2057-62
pubmed: 16697325
Heart. 2019 Nov;105(22):1732-1740
pubmed: 31292191
Ann Thorac Surg. 2011 Nov;92(5):1742-6
pubmed: 21925641
Circulation. 1984 Aug;70(2):202-8
pubmed: 6733876
Circulation. 2018 Nov 6;138(19):2119-2129
pubmed: 30474422
J Cardiol. 2017 Jan;69(1):208-215
pubmed: 27118699
Eur J Cardiothorac Surg. 2001 Jul;20(1):82-8
pubmed: 11423279
Circulation. 1993 Aug;88(2):615-20
pubmed: 8339425
Ann Thorac Surg. 2013 May;95(5):1654-9
pubmed: 23218968
Ann Thorac Surg. 2019 Mar;107(3):691-704
pubmed: 30641069
Circulation. 2004 Sep 14;110(11 Suppl 1):II128-32
pubmed: 15364851
Interact Cardiovasc Thorac Surg. 2016 Aug;23(2):240-6
pubmed: 27141085
Pediatr Cardiol. 2004 Jul-Aug;25(4):329-35
pubmed: 14727099
J Thorac Cardiovasc Surg. 1976 Sep;72(3):364-70
pubmed: 957754
Eur J Cardiothorac Surg. 2012 Nov;42(5):794-9; discussion 799
pubmed: 22723618
Cardiol Young. 2006 Oct;16(5):481-9
pubmed: 16984700
Ann Thorac Surg. 2011 Sep;92(3):973-9
pubmed: 21871285