Survival into adulthood of patients with atrial isomerism undergoing cardiac surgery

The Journal of Thoracic and Cardiovascular Surgery
Jayapadman BhaskarYves d'Udekem

Abstract

To identify determinants of adverse outcomes in patients with atrial isomerism. Determinants of survival were analyzed for the group as a whole as well as separately for left and right atrial isomerism. There were 78 cases with right and 104 with left atrial isomerism. Nineteen patients were not offered surgery; 49 (47%) of those with left atrial isomerism and 60 (77%) with right atrial isomerism were directed to single ventricle palliation. A total of 67 patients died. Survival to 25 years was 62% (95% confidence interval [CI], 53%-69%). Independent predictors of mortality were obstructed total anomalous pulmonary venous drainage (P < .001; hazard ratio [HR], 5.2; 95% CI, 2.7-9.7) and asplenia (P = .008; HR, 2; 95% CI, 1.2-3.3). There was no evidence that patients born in the recent era had improved survival (P = .47; HR, 1.1; 95% CI, 0.8-1.5). Survival was better for patients with left than right atrial isomerism: 18 years survival 74% (95% CI, 63%-82%) versus 50% (95% CI, 38%-60%). Independent predictors of mortality for patients with left atrial isomerism were dextrocardia (P = .009; HR, 3.0; 95% CI, 1.3-6.7) and pulmonary stenosis (P = .042; HR, 0.3; 95% CI, 0.1-0.9) and patients with right atrial isomerism, biventricular ...Continue Reading

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Citations

Apr 18, 2016·The Journal of Thoracic and Cardiovascular Surgery·Bahaaldin AlsoufiKirk Kanter
May 10, 2015·The Journal of Thoracic and Cardiovascular Surgery·Glen S Van Arsdell
Dec 15, 2019·World Journal for Pediatric & Congenital Heart Surgery·Bahaaldin AlsoufiBrian Kogon
Oct 17, 2019·Congenital Heart Disease·Christopher R BrodaHeather A Dickerson
Jul 8, 2020·Molecular Genetics & Genomic Medicine·Amirpouyan NamavarianVarsha Thakur
Mar 23, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Kenta ImaiKisaburo Sakamoto
Nov 17, 2020·Circulation. Genomic and Precision Medicine·Alvin Chun Hang MaBrian Hon Yin Chung
Dec 16, 2020·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mei-Hwan WuChun-An Chen
Mar 31, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Janez VodiskarMasamichi Ono
Sep 9, 2021·Journal of Cardiac Surgery·Diego B Ortega-ZhindónJorge L Cervantes-Salazar

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