Long-Term Survival After Arterial Versus Atrial Switch in d-Transposition of the Great Arteries

The Annals of Thoracic Surgery
Alexander KienerMatthew E Oster

Abstract

The arterial switch operation (ASO) became the procedure of choice for dextro-transposition of the great arteries (d-TGA) nearly 30 years ago, but the long-term results of this operation are unknown. We aimed to compare the long-term transplant-free survival of patients with d-TGA who underwent ASO versus atrial switch in the Pediatric Cardiac Care Consortium. We performed a retrospective cohort study of d-TGA patients undergoing ASO or atrial switch in the United States between 1982 and 1991. Long-term transplant-free survival was obtained by linking Pediatric Cardiac Care Consortium data with the National Death Index and the Organ Procurement and Transplant Network. Kaplan-Meier survival plots were constructed, and multivariable regression was used to compare long-term transplant-free survival. Of 554 d-TGA patients who underwent ASO (n = 259) or atrial switch (n = 295), the 20-year overall transplant-free survival was 82.1% for those undergoing ASO and 76.3% for those who had atrial switch procedure. Adjusted overall transplant-free survival beyond 10 years after operation was superior for ASO compared with atrial switch (hazard ratio 0.07, 95% confidence interval: 0.01 to 0.52, p = 0.009). During this period, the ASO had hi...Continue Reading

Citations

Oct 24, 2019·Journal of the American Heart Association·Prashanth VenkateshHarsimran S Singh
Nov 13, 2020·Seminars in Thoracic and Cardiovascular Surgery·Sitaram M Emani
Apr 30, 2020·International Journal of Cardiology·Béatrice SantensWerner Budts
Nov 2, 2019·The Journal of Thoracic and Cardiovascular Surgery·Jonathan M Chen

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