Five-year Experience With Arterial Switch Operation in the First Hours of Life

被引:8
作者
Chasovskyi, Kyrylo [1 ]
Mykychak, Yaroslav [2 ]
Rudenko, Nadiia [3 ]
Vorobyova, Hanna [3 ]
Yemets, Illya [2 ]
机构
[1] Ukrainian Childrens Cardiac Ctr, Dept Intens Care & Perfusiol, Chornovola St 28-1, UA-01135 Kiev, Ukraine
[2] Ukrainian Childrens Cardiac Ctr, Dept Cardiac Surg, Kiev, Ukraine
[3] Ukrainian Childrens Cardiac Ctr, Dept Cardiol, Kiev, Ukraine
关键词
blood; CHD; arterial switch operation; neonates; cardiopulmonary bypass; UMBILICAL-CORD BLOOD; OPEN-HEART-SURGERY; GREAT-ARTERIES; PRENATAL-DIAGNOSIS; TISSUE PERFUSION; CARDIAC-SURGERY; D-TRANSPOSITION; OUTCOMES; MORBIDITY; IMPACT;
D O I
10.1053/j.semtcvs.2017.01.011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We assessed morbidity after 2 management strategies for arterial switch operation (ASO) in a single institution: first hours of life surgery and conventional approach. From September 2009 to September 2014, 346 consecutive patients who underwent ASO were enrolled. The study group included 92 patients who underwent ASO in the first 24 hours after birth (group I). The control group consisted of 254 patients who underwent ASO after 24 hours of life in the conventional way (group II). Three outcomes were analyzed: postoperative ventilation time (VT), post-extubation hospital length of stay (peLOS), and a composite morbidity index, defined as postoperative VT + peLOS + occurrence of selected major complications. Overall 30-day survival was 98% (2 [2%] group I vs 5 [2%] group II, P = 1.000). Fifty (13.3%) major complications were observed: 14 (15%) in group I and 36 (15%) in group II (P = 0.635). Although peLOS and morbidity index did not differ significantly between groups, postoperative VT (42 hours [24, 67] vs 27 hours [22, 47], P = 0.008) and total hospital stay were significantly longer in group II (18 days [10, 19] vs 14 days [12, 18]). A median volume of 80 mL (60-100 mL) of autologous umbilical cord blood was collected (80 mL, group 1 vs 60 mL, group II; P = 0.090). Homologous blood cell transfusion was avoided in 70 patients (78%) in group I and in 13 patients (6%) in group II (P < 0.001). Arterial switch operation during the initial 24 hours of life has similar outcomes in view of morbidity and mortality to the conventional approach. © 2017 Elsevier Inc.
引用
收藏
页码:70 / 76
页数:7
相关论文
共 24 条
[1]   Earlier Arterial Switch Operation Improves Outcomes and Reduces Costs for Neonates With Transposition of the Great Arteries [J].
Anderson, Brett R. ;
Ciarleglio, Adam J. ;
Hayes, Denise A. ;
Quaegebeur, Jan M. ;
Vincent, Julie A. ;
Bacha, Emile A. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2014, 63 (05) :481-487
[2]   Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality [J].
Bonnet, D ;
Coltri, A ;
Butera, G ;
Fermont, L ;
Le Bidois, J ;
Kachaner, J ;
Sidi, D .
CIRCULATION, 1999, 99 (07) :916-918
[3]   Effect of Prostaglandin Duration on Outcomes in Transposition of the Great Arteries with Intact Ventricular Septum [J].
Butts, Ryan J. ;
Ellis, Alexander R. ;
Bradley, Scott M. ;
Hulsey, Thomas C. ;
Atz, Andrew M. .
CONGENITAL HEART DISEASE, 2012, 7 (04) :387-391
[4]   Tissue perfusion in neonates undergoing open-heart surgery using autologous umbilical cord blood or donor blood components [J].
Chasovskyi, K. ;
Fedevych, O. ;
McMullan, D. M. ;
Mykychak, Y. ;
Vorobiova, G. ;
Zhovnir, V. ;
Yemets, I. .
PERFUSION-UK, 2015, 30 (06) :499-506
[5]   Impact of carbon dioxide tension during cardiopulmonary bypass on tissue perfusion in neonates undergoing cardiac surgery using autologous umbilical cord blood [J].
Chasovskyi, Kyrylo ;
Yemets, Illya .
PERFUSION-UK, 2016, 31 (05) :418-423
[6]   Arterial Switch Operation in the First Hours of Life Using Autologous Umbilical Cord Blood [J].
Chasovskyi, Kyrylo ;
Fedevych, Oleg ;
Vorobiova, Ganna ;
Zhovnir, Volodymyr ;
Maksimenko, Andriy ;
Boychenko, Olena ;
Lysak, Yuriy ;
Cohen, Gordon ;
Yemets, Illya .
ANNALS OF THORACIC SURGERY, 2012, 93 (05) :1571-1576
[7]   Postoperative lactate concentrations predict the outcome of infants aged 6 weeks or less after intracardiac surgery: A cohort follow-up to 18 months [J].
Cheung, PY ;
Chui, N ;
Joffe, AR ;
Rebeyka, IM ;
Robertson, CMT .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2005, 130 (03) :837-843
[8]   Current expectations for Newborns undergoing the arterial switch operation [J].
Dibardino, DJ ;
Allison, AE ;
Vaughn, WK ;
McKenzie, ED ;
Fraser, CD .
ANNALS OF SURGERY, 2004, 239 (05) :588-596
[9]   Selective timing for the arterial switch operation [J].
Duncan, BW ;
Poirier, NC ;
Mee, RBB ;
Drummond-Webb, JJ ;
Qureshi, A ;
Mesia, CI ;
Graney, JA ;
Malek, CL ;
Latson, LA .
ANNALS OF THORACIC SURGERY, 2004, 77 (05) :1691-1697
[10]   Prenatal diagnosis of transposition of the great arteries over a 20-year period: improved but imperfect [J].
Escobar-Diaz, M. C. ;
Freud, L. R. ;
Bueno, A. ;
Brown, D. W. ;
Friedman, K. G. ;
Schidlow, D. ;
Emani, S. ;
Del Nido, P. J. ;
Tworetzky, W. .
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2015, 45 (06) :678-682