The arterial switch operation in Europe for transposition of the great arteries: A multi-institutional study from the European Congenital Heart Surgeons Association

George E. Sarris, Andrew C. Chatzis, Nicolas M. Giannopoulos, George Kirvassilis, Hakan Berggren, Mark Hazekamp, Thierry Carrel, Juan V. Comas, Duccio Di Carlo, Willem Daenen, Tjark Ebels, Josè Fragata, Victor Hraska, Vladimir Ilyin, Harald L. Lindberg, Dominique Metras, Marco Pozzi, Jean Rubay, Heikki Sairanen, Giovanni StellinAndreas Urban, Carin Van Doorn, Gerhard Ziemer

Research output: Contribution to journalArticle

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Abstract

Objectives: This study analyzes the results of the arterial switch operation for transposition of the great arteries in member institutions of the European Congenital Heart Surgeons Association. Methods: The records of 613 patients who underwent primary arterial switch operations in each of 19 participating institutions in the period from January 1998 through December 2000 were reviewed retrospectively. Results: A ventricular septal defect was present in 186 (30%) patients. Coronary anatomy was type A in 69% of the patients, and aortic arch pathology was present in 20% of patients with ventricular septal defect. Rashkind septostomy was performed in 75% of the patients, and 69% received prostaglandin. There were 37 hospital deaths (operative mortality, 6%), 13 (3%) for patients with an intact ventricular septum and 24 (13%) for those with a ventricular septal defect (P <.001). In 36% delayed sternal closure was performed, 8% required peritoneal dialysis, and 2% required mechanical circulatory support. Median ventilation time was 58 hours, and intensive care and hospital stay were 6 and 14 days, respectively. Although of various preoperative risk factors the presence of a ventricular septal defect, arch pathology, and coronary anomalies were univariate predictors of operative mortality, only the presence of a ventricular septal defect approached statistical significance (P = .06) on multivariable analysis. Of various operative parameters, aortic crossclamp time and delayed sternal closure were also univariate predictors; however, only the latter was an independent statistically significant predictor of death. Conclusions: Results of the procedure in European centers are compatible with those in the literature. The presence of a ventricular septal defect is the clinically most important preoperative risk factor for operative death, approaching statistical significance on multivariable analysis.

Original languageEnglish
Pages (from-to)633-639
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume132
Issue number3
DOIs
Publication statusPublished - Sep 2006

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Transposition of Great Vessels
Ventricular Heart Septal Defects
Pathology
Ventricular Septum
Mortality
Peritoneal Dialysis
Critical Care
Thoracic Aorta
Prostaglandins
Ventilation
Arterial Switch Operation
Length of Stay
Anatomy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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The arterial switch operation in Europe for transposition of the great arteries : A multi-institutional study from the European Congenital Heart Surgeons Association. / Sarris, George E.; Chatzis, Andrew C.; Giannopoulos, Nicolas M.; Kirvassilis, George; Berggren, Hakan; Hazekamp, Mark; Carrel, Thierry; Comas, Juan V.; Di Carlo, Duccio; Daenen, Willem; Ebels, Tjark; Fragata, Josè; Hraska, Victor; Ilyin, Vladimir; Lindberg, Harald L.; Metras, Dominique; Pozzi, Marco; Rubay, Jean; Sairanen, Heikki; Stellin, Giovanni; Urban, Andreas; Van Doorn, Carin; Ziemer, Gerhard.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 132, No. 3, 09.2006, p. 633-639.

Research output: Contribution to journalArticle

Sarris, GE, Chatzis, AC, Giannopoulos, NM, Kirvassilis, G, Berggren, H, Hazekamp, M, Carrel, T, Comas, JV, Di Carlo, D, Daenen, W, Ebels, T, Fragata, J, Hraska, V, Ilyin, V, Lindberg, HL, Metras, D, Pozzi, M, Rubay, J, Sairanen, H, Stellin, G, Urban, A, Van Doorn, C & Ziemer, G 2006, 'The arterial switch operation in Europe for transposition of the great arteries: A multi-institutional study from the European Congenital Heart Surgeons Association', Journal of Thoracic and Cardiovascular Surgery, vol. 132, no. 3, pp. 633-639. https://doi.org/10.1016/j.jtcvs.2006.01.065
Sarris, George E. ; Chatzis, Andrew C. ; Giannopoulos, Nicolas M. ; Kirvassilis, George ; Berggren, Hakan ; Hazekamp, Mark ; Carrel, Thierry ; Comas, Juan V. ; Di Carlo, Duccio ; Daenen, Willem ; Ebels, Tjark ; Fragata, Josè ; Hraska, Victor ; Ilyin, Vladimir ; Lindberg, Harald L. ; Metras, Dominique ; Pozzi, Marco ; Rubay, Jean ; Sairanen, Heikki ; Stellin, Giovanni ; Urban, Andreas ; Van Doorn, Carin ; Ziemer, Gerhard. / The arterial switch operation in Europe for transposition of the great arteries : A multi-institutional study from the European Congenital Heart Surgeons Association. In: Journal of Thoracic and Cardiovascular Surgery. 2006 ; Vol. 132, No. 3. pp. 633-639.
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AU - Chatzis, Andrew C.

AU - Giannopoulos, Nicolas M.

AU - Kirvassilis, George

AU - Berggren, Hakan

AU - Hazekamp, Mark

AU - Carrel, Thierry

AU - Comas, Juan V.

AU - Di Carlo, Duccio

AU - Daenen, Willem

AU - Ebels, Tjark

AU - Fragata, Josè

AU - Hraska, Victor

AU - Ilyin, Vladimir

AU - Lindberg, Harald L.

AU - Metras, Dominique

AU - Pozzi, Marco

AU - Rubay, Jean

AU - Sairanen, Heikki

AU - Stellin, Giovanni

AU - Urban, Andreas

AU - Van Doorn, Carin

AU - Ziemer, Gerhard

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N2 - Objectives: This study analyzes the results of the arterial switch operation for transposition of the great arteries in member institutions of the European Congenital Heart Surgeons Association. Methods: The records of 613 patients who underwent primary arterial switch operations in each of 19 participating institutions in the period from January 1998 through December 2000 were reviewed retrospectively. Results: A ventricular septal defect was present in 186 (30%) patients. Coronary anatomy was type A in 69% of the patients, and aortic arch pathology was present in 20% of patients with ventricular septal defect. Rashkind septostomy was performed in 75% of the patients, and 69% received prostaglandin. There were 37 hospital deaths (operative mortality, 6%), 13 (3%) for patients with an intact ventricular septum and 24 (13%) for those with a ventricular septal defect (P <.001). In 36% delayed sternal closure was performed, 8% required peritoneal dialysis, and 2% required mechanical circulatory support. Median ventilation time was 58 hours, and intensive care and hospital stay were 6 and 14 days, respectively. Although of various preoperative risk factors the presence of a ventricular septal defect, arch pathology, and coronary anomalies were univariate predictors of operative mortality, only the presence of a ventricular septal defect approached statistical significance (P = .06) on multivariable analysis. Of various operative parameters, aortic crossclamp time and delayed sternal closure were also univariate predictors; however, only the latter was an independent statistically significant predictor of death. Conclusions: Results of the procedure in European centers are compatible with those in the literature. The presence of a ventricular septal defect is the clinically most important preoperative risk factor for operative death, approaching statistical significance on multivariable analysis.

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