Biventricular strategies for neonatal critical aortic stenosis: High mortality associated with early reintervention

Objective To characterize the risk of reintervention after biventricular strategies to treat neonatal critical aortic stenosis, and the effect of reintervention on survival. Methods In a multi-institutional inception cohort of 139 neonates, the time-related risk of reintervention was analyzed using...

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Veröffentlicht in:	The Journal of thoracic and cardiovascular surgery 2012-08, Vol.144 (2), p.409-417.e1
Hauptverfasser:	Hickey, Edward J., MD, Caldarone, Christopher A., MD, Blackstone, Eugene H., MD, Williams, William G., MD, Yeh, Tom, MD, Pizarro, Christian, MD, Lofland, Gary, MD, Tchervenkov, Christo I., MD, Pigula, Frank, MD, McCrindle, Brian W., MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Aortic Valve Stenosis - mortality Aortic Valve Stenosis - physiopathology Aortic Valve Stenosis - therapy Biological and medical sciences Cardiac Surgical Procedures - methods Cardiac Surgical Procedures - mortality Cardiology. Vascular system Cardiothoracic Surgery Catheterization Female Heart Ventricles - surgery Humans Infant, Newborn Male Medical sciences Models, Statistical Pneumology Prognosis Risk Assessment Risk Factors Survival Analysis Ventricular Dysfunction, Left - epidemiology Ventricular Outflow Obstruction - physiopathology
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Zusammenfassung:	Objective To characterize the risk of reintervention after biventricular strategies to treat neonatal critical aortic stenosis, and the effect of reintervention on survival. Methods In a multi-institutional inception cohort of 139 neonates, the time-related risk of reintervention was analyzed using parametric multiphase competing-risk models and a modulated renewal repeated-events method. The risk factors were identified through multivariate regression and selected with bootstrap resampling for reliability. Univentricular survival predictions were generated using the Congenital Heart Surgeons' Society Univentricular Repair Survival Advantage score. Results One half of survivors required reintervention within 3 years. The risk of undergoing early reintervention decreased with successive procedures ( P
ISSN:	0022-5223 1097-685X
DOI:	10.1016/j.jtcvs.2011.09.076