Interventions after Arterial Switch: A Single Low Case-Volume Center Experience
<i>Background and Objectives</i>: With the growing population of arterial switch operation survivors, the rate of late complications associated with the operation is growing as well. The aim of this publication is to share our experience and encourage collaboration between congenital car...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/5/401 |
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| author | Karolis Jonas Virginijus Jakutis Rita Sudikienė Virgilijus Lebetkevičius Virgilijus Tarutis |
| author_facet | Karolis Jonas Virginijus Jakutis Rita Sudikienė Virgilijus Lebetkevičius Virgilijus Tarutis |
| author_sort | Karolis Jonas |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: With the growing population of arterial switch operation survivors, the rate of late complications associated with the operation is growing as well. The aim of this publication is to share our experience and encourage collaboration between congenital cardiac surgeons and interventional cardiologists in treating late complications after arterial switch operation. <i>Materials and Methods</i>: A retrospective analysis of Vilnius University Santaros Clinics Cardiothoracic Surgery Centre arterial switch operation survivors who underwent additional treatment for late neo-pulmonary artery stenosis and aortic arch obstruction between 1989 and 2019 was conducted. <i>Results</i>: Out of 95 arterial switch operation survivors 14 (15%) underwent 36 reinterventions. The majority were treated for neo-pulmonary stenosis. The median time from arterial switch operation to the first reintervention was 1.4 years (interquartile range, 2 months to 2.4 years). 1, 3, 5, and 10 years intervention-free survival in patients treated for neo-pulmonary stenosis and aortic arch obstruction was 98, 94, 94, and 93% vs. 95, 94, 94, and 93%, respectively. There were no complications associated with redo surgical procedures, while eight patients who underwent catheter-based interventional treatment had treatment-related complications, including one death. <i>Conclusions</i>: Both neo-pulmonary stenosis and aortic arch obstruction (new aortic coarctations or aortic recoarctations) tend to develop in the first decade after an arterial switch operation. Surgical and catheter-based interventional treatment with good results is possible even in a small volume center. Close collaboration of the congenital heart team (congenital cardiac surgeons and interventional cardiologists) in choosing the best treatment option for an individual patient helps to minimize the risk of potential complications. |
| first_indexed | 2024-03-10T12:08:01Z |
| format | Article |
| id | doaj.art-d148d037cc3743ff876f4b5dab37d89d |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T12:08:01Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-d148d037cc3743ff876f4b5dab37d89d2023-11-21T16:25:39ZengMDPI AGMedicina1010-660X1648-91442021-04-0157540110.3390/medicina57050401Interventions after Arterial Switch: A Single Low Case-Volume Center ExperienceKarolis Jonas0Virginijus Jakutis1Rita Sudikienė2Virgilijus Lebetkevičius3Virgilijus Tarutis4Center of Cardiothoracic Surgery, Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Santariskiu St. 2, LT-08661 Vilnius, LithuaniaClinic of Anesthesiology and Intensive Care, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Santariskiu St. 2, LT-08661 Vilnius, LithuaniaCenter of Cardiothoracic Surgery, Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Santariskiu St. 2, LT-08661 Vilnius, LithuaniaCenter of Cardiothoracic Surgery, Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Santariskiu St. 2, LT-08661 Vilnius, LithuaniaCenter of Cardiothoracic Surgery, Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Santariskiu St. 2, LT-08661 Vilnius, Lithuania<i>Background and Objectives</i>: With the growing population of arterial switch operation survivors, the rate of late complications associated with the operation is growing as well. The aim of this publication is to share our experience and encourage collaboration between congenital cardiac surgeons and interventional cardiologists in treating late complications after arterial switch operation. <i>Materials and Methods</i>: A retrospective analysis of Vilnius University Santaros Clinics Cardiothoracic Surgery Centre arterial switch operation survivors who underwent additional treatment for late neo-pulmonary artery stenosis and aortic arch obstruction between 1989 and 2019 was conducted. <i>Results</i>: Out of 95 arterial switch operation survivors 14 (15%) underwent 36 reinterventions. The majority were treated for neo-pulmonary stenosis. The median time from arterial switch operation to the first reintervention was 1.4 years (interquartile range, 2 months to 2.4 years). 1, 3, 5, and 10 years intervention-free survival in patients treated for neo-pulmonary stenosis and aortic arch obstruction was 98, 94, 94, and 93% vs. 95, 94, 94, and 93%, respectively. There were no complications associated with redo surgical procedures, while eight patients who underwent catheter-based interventional treatment had treatment-related complications, including one death. <i>Conclusions</i>: Both neo-pulmonary stenosis and aortic arch obstruction (new aortic coarctations or aortic recoarctations) tend to develop in the first decade after an arterial switch operation. Surgical and catheter-based interventional treatment with good results is possible even in a small volume center. Close collaboration of the congenital heart team (congenital cardiac surgeons and interventional cardiologists) in choosing the best treatment option for an individual patient helps to minimize the risk of potential complications.https://www.mdpi.com/1648-9144/57/5/401late complications after arterial switch operationpulmonary stenosis after arterial switch operationaortic arch obstruction after arterial switch operationcatheter-based treatment after arterial switch operation |
| spellingShingle | Karolis Jonas Virginijus Jakutis Rita Sudikienė Virgilijus Lebetkevičius Virgilijus Tarutis Interventions after Arterial Switch: A Single Low Case-Volume Center Experience Medicina late complications after arterial switch operation pulmonary stenosis after arterial switch operation aortic arch obstruction after arterial switch operation catheter-based treatment after arterial switch operation |
| title | Interventions after Arterial Switch: A Single Low Case-Volume Center Experience |
| title_full | Interventions after Arterial Switch: A Single Low Case-Volume Center Experience |
| title_fullStr | Interventions after Arterial Switch: A Single Low Case-Volume Center Experience |
| title_full_unstemmed | Interventions after Arterial Switch: A Single Low Case-Volume Center Experience |
| title_short | Interventions after Arterial Switch: A Single Low Case-Volume Center Experience |
| title_sort | interventions after arterial switch a single low case volume center experience |
| topic | late complications after arterial switch operation pulmonary stenosis after arterial switch operation aortic arch obstruction after arterial switch operation catheter-based treatment after arterial switch operation |
| url | https://www.mdpi.com/1648-9144/57/5/401 |
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