Characteristics and Operative Outcomes for Children Undergoing Repair of Truncus Arteriosus: A Contemporary Multicenter Analysis

dc.contributor.authorMastropietro, Christopher W.
dc.contributor.authorAmula, Venu
dc.contributor.authorSassalos, Peter
dc.contributor.authorBuckley, Jason R.
dc.contributor.authorSmerling, Arthur J.
dc.contributor.authorIliopoulos, Illias
dc.contributor.authorRiley, Christine M.
dc.contributor.authorJennings, Aimee
dc.contributor.authorCashen, Katherine
dc.contributor.authorNarasimhulu, Sukumar Suguna
dc.contributor.authorGowda, Keshava Murty Narayana
dc.contributor.authorBakar, Adnan M.
dc.contributor.authorWilhelm, Michael
dc.contributor.authorBadheka, Aditya
dc.contributor.authorMoser, Elizabeth A. S.
dc.contributor.authorCostello, John M.
dc.contributor.departmentPediatrics, School of Medicineen_US
dc.date.accessioned2019-03-20T17:43:39Z
dc.date.available2019-03-20T17:43:39Z
dc.date.issued2019
dc.description.abstractObjective We sought to describe characteristics and operative outcomes of children who underwent repair of truncus arteriosus and identify risk factors for the occurrence of major adverse cardiac events (MACE) in the immediate postoperative period in a contemporary multicenter cohort. Methods We conducted a retrospective review of children who underwent repair of truncus arteriosus between 2009 and 2016 at 15 centers within the United States. Patients with associated interrupted or obstructed aortic arch were excluded. MACE was defined as the need for postoperative extracorporeal membrane oxygenation (ECMO), cardiopulmonary resuscitation (CPR), or operative mortality. Risk factors for MACE were identified using multivariable logistic regression analysis and reported as odds ratios (OR) with 95% confidence intervals (CI). Results We reviewed 216 patients. MACE occurred in 44 patients (20%) and did not vary significantly over time. Twenty-two patients (10%) received postoperative ECMO, 26 (12%) received CPR, and 15 (7%) suffered operative mortality. With multivariable logistic regression analysis (which included adjustment for center effect), factors independently associated with MACE were failure to diagnose truncus arteriosus prior to discharge from the nursery (OR:3.1; 95%CI:1.3,7.4), cardiopulmonary bypass duration greater than 150 minutes (OR:3.5; 95%CI:1.5,8.5), and right ventricle-to-pulmonary artery conduit diameter greater than 50mm/m2 (OR:4.7; 95%CI:2.0,11.1). Conclusions In a contemporary multicenter analysis, 20% of children undergoing repair of truncus arteriosus experienced MACE. Early diagnosis, shorter duration of cardiopulmonary bypass, and use of smaller diameter right ventricle-to-pulmonary artery conduits represent potentially modifiable factors that could decrease morbidity and mortality in this fragile patient population.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationMastropietro, C. W., Amula, V., Sassalos, P., Buckley, J. R., Smerling, A. J., Iliopoulos, I., … Costello, J. M. (2019). Characteristics and Operative Outcomes for Children Undergoing Repair of Truncus Arteriosus: A Contemporary Multicenter Analysis. The Journal of Thoracic and Cardiovascular Surgery. https://doi.org/10.1016/j.jtcvs.2018.12.115en_US
dc.identifier.urihttps://hdl.handle.net/1805/18662
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.isversionof10.1016/j.jtcvs.2018.12.115en_US
dc.relation.journalThe Journal of Thoracic and Cardiovascular Surgeryen_US
dc.rightsPublisher Policyen_US
dc.sourceAuthoren_US
dc.subjecttruncus arteriosusen_US
dc.subjectcardiopulmonary bypassen_US
dc.subjectrisk factorsen_US
dc.titleCharacteristics and Operative Outcomes for Children Undergoing Repair of Truncus Arteriosus: A Contemporary Multicenter Analysisen_US
dc.typeArticleen_US
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