Intermediate-term mortality and cardiac transplantation in infants with single-ventricle lesions: Risk factors and their interaction with shunt type

Objective The study objective was to identify factors associated with death and cardiac transplantation in infants undergoing the Norwood procedure and to determine differences in associations that might favor the modified Blalock–Taussig shunt or a right ventricle-to-pulmonary artery shunt. Methods...

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Veröffentlicht in:The Journal of thoracic and cardiovascular surgery 2012-07, Vol.144 (1), p.152-159.e2
Hauptverfasser: Tweddell, James S., MD, Sleeper, Lynn A., ScD, Ohye, Richard G., MD, Williams, Ismee A., MD, MS, Mahony, Lynn, MD, Pizarro, Christian, MD, Pemberton, Victoria L., RNC, MS, Frommelt, Peter C., MD, Bradley, Scott M., MD, Cnota, James F., MD, Hirsch, Jennifer, MD, MS, Kirshbom, Paul M., MD, Li, Jennifer S., MD, MHS, Pike, Nancy, RN, PhD, Puchalski, Michael, MD, Ravishankar, Chitra, MD, Jacobs, Jeffrey P., MD, Laussen, Peter C., MBBS, McCrindle, Brian W., MD, MPH
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Sprache:eng
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Zusammenfassung:Objective The study objective was to identify factors associated with death and cardiac transplantation in infants undergoing the Norwood procedure and to determine differences in associations that might favor the modified Blalock–Taussig shunt or a right ventricle-to-pulmonary artery shunt. Methods We used competing risks methodology to analyze death without transplantation, cardiac transplantation, and survival without transplantation. Parametric time-to-event modeling and bootstrapping were used to identify independent predictors. Results Data from 549 subjects (follow-up, 2.7 ± 0.9 years) were analyzed. Mortality risk was characterized by early and constant phases; transplant was characterized by only a constant phase. Early phase factors associated with death included lower socioeconomic status ( P  = .01), obstructed pulmonary venous return ( P  
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2012.01.016