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      Association between balloon atrial septostomy and prostaglandin E1 therapy until repair of transposition of the great arteries in neonates

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          Abstract

          In patients with transposition of the great arteries, the continuation of prostaglandin E1 is more frequent in patients with intact ventricular septum in comparison to patients with ventricular septal defect. Ballon atrial septostomy did not eliminate the need for prostaglandin E1 infusion until the time of surgery in both subgroups of patients.

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          D-transposition of the great arteries: the current era of the arterial switch operation.

          Juan Villafañe, M Lantin-Hermoso, Ami B Bhatt … (2014)
          This paper aims to update clinicians on "hot topics" in the management of patients with D-loop transposition of the great arteries (D-TGA) in the current surgical era. The arterial switch operation (ASO) has replaced atrial switch procedures for D-TGA, and 90% of patients now reach adulthood. The Adult Congenital and Pediatric Cardiology Council of the American College of Cardiology assembled a team of experts to summarize current knowledge on genetics, pre-natal diagnosis, surgical timing, balloon atrial septostomy, prostaglandin E1 therapy, intraoperative techniques, imaging, coronary obstruction, arrhythmias, sudden death, neoaortic regurgitation and dilation, neurodevelopmental (ND) issues, and lifelong care of D-TGA patients. In simple D-TGA: 1) familial recurrence risk is low; 2) children diagnosed pre-natally have improved cognitive skills compared with those diagnosed post-natally; 3) echocardiography helps to identify risk factors; 4) routine use of BAS and prostaglandin E1 may not be indicated in all cases; 5) early ASO improves outcomes and reduces costs with a low mortality; 6) single or intramural coronary arteries remain risk factors; 7) post-ASO arrhythmias and cardiac dysfunction should raise suspicion of coronary insufficiency; 8) coronary insufficiency and arrhythmias are rare but are associated with sudden death; 9) early- and late-onset ND abnormalities are common; 10) aortic regurgitation and aortic root dilation are well tolerated; and 11) the aging ASO patient may benefit from "exercise-prescription" rather than restriction. Significant strides have been made in understanding risk factors for cardiac, ND, and other important clinical outcomes after ASO.
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            Evolution of risk factors influencing early mortality of the arterial switch operation.

            Elizabeth D Blume, Karen Altmann, John Mayer … (1999)
            The present study was undertaken to determine the independent risk factors for early mortality in the current era after arterial switch operation (ASO). Prior reports on factors affecting outcome of the ASO demonstrated that abnormal coronary arterial patterns were associated with increased risk of early mortality. As diagnostic, surgical and perioperative management techniques continue to evolve, the risk factors for the ASO may have changed. All patients who underwent the ASO at Children's Hospital, Boston between January 1, 1992 and December 31, 1996 were included. Hospital charts, echocardiographic and cardiac catheterization data and operative reports of all patients were reviewed. Demographics and preoperative, intraoperative and postoperative variables were recorded. Of the 223 patients included in the study (median age at ASO = 6 days and median weight = 3.5 kg), 26 patients had aortic arch obstruction or interruption, 12 had Taussig-Bing anomaly, 12 had multiple ventricular septal defects, 8 had right ventricular hypoplasia and 6 were premature. There were 16 early deaths (7%), with 3 deaths in the 109 patients considered "low risk" (2.7%). Coronary artery pattern was not associated with an increased risk of death. Compared with usual coronary anatomy pattern, however, inverted coronary patterns and single right coronary patterns were associated with increased incidence of delayed sternal closure (p = 0.003) and longer duration of mechanical ventilation (p = 0.008). In a multivariate logistic regression model using only preoperative variables, aortic arch repair at a separate procedure before ASO and smaller birth weight were independent predictors of early mortality. In a second model that included both pre- and intraoperative variables, circulatory arrest time and right ventricular hypoplasia were independent predictors of early death. The ASO can be performed in the current era without excess early mortality related to uncommon coronary artery patterns. Aortic arch repair before ASO, right ventricular hypoplasia, lower birth weight and longer intraoperative support continue to be independent risk factors for early mortality after the ASO.
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              Clinical guidelines for the management of patients with transposition of the great arteries with intact ventricular septum.

              Joerg Stein, Matthias Siepe, George E Sarris … (2017)
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                Author and article information

                Contributors
                Sebastian Acosta:
                ORCID: https://orcid.org/0000-0003-4935-5534
                sacosta@bcm.edu
                Journal
                Journal ID (nlm-ta): Pediatr Investig
                Journal ID (iso-abbrev): Pediatr Investig
                Journal ID (doi): 10.1002/(ISSN)2574-2272
                Journal ID (publisher-id): PED4
                Title: Pediatric Investigation
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 2096-3726
                ISSN (Electronic): 2574-2272
                Publication date (Electronic): 08 April 2024
                Publication date Collection: June 2024
                Volume: 8
                Issue: 2 ( doiID: 10.1002/ped4.v8.2 )
                Pages: 135-138
                Affiliations
                [ 1 ] Department of Pediatrics Divisions of Critical Care Medicine and Cardiology Texas Children's Hospital and Baylor College of Medicine Houston Texas USA
                [ 2 ] Department of Pediatrics Division of Cardiology Texas Children's Hospital and Baylor College of Medicine Houston Texas USA
                [ 3 ] Department of Pediatrics The Heart Institute Advocate Children's Hospital Chicago Medical School and Rosalind Franklin University of Medicine and Science Oak Lawn Illinois USA
                [ 4 ] Department of Anesthesiology Arthur S. Keats Division of Pediatric Cardiovascular Anesthesia Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine Houston Texas USA
                Author notes
                [*] [* ] Correspondence

                Sebastian Acosta, Department of Pediatrics, Division of Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.

                Email: sacosta@ 123456bcm.edu

                Author information
                https://orcid.org/0000-0003-4935-5534
                Article
                Publisher ID: PED412425
                DOI: 10.1002/ped4.12425
                PMC ID: 11193373
                PubMed ID: 38910849
                SO-VID: 334f9f29-5e55-4c5d-bd4a-1642fa1dd8ba
                Copyright © © 2024 Chinese Medical Association. Pediatric Investigation published by John Wiley & Sons Australia, Ltd on behalf of Futang Research Center of Pediatric Development.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date received : 04 January 2024
                Date accepted : 13 March 2024
                Page count
                Figures: 2, Tables: 0, Pages: 4, Words: 2964
                Categories
                Subject: Research Letter
                Subject: Research Letter
                Custom metadata
                source-schema-version-number 2.0
                cover-date June 2024
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.4 mode:remove_FC converted:22.06.2024

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