Abstract
Objective: We evaluated long-term results of surgical correction of congenital cardiac anomalies in infancy.Methods: We reviewed cases of 856 patients who underwent complete correction of major cardiac anomalies in the first year of life during last 24 years at our institution, and analyzed results. Surgery involved ventricular septal defect (n=453), tetralogy of Fallot (n=92), atrioventricular canal defect (n=93), and complete transposition of the great arteries (n=218).Results: Operative mortality was 2.2% in ventricular septal defect, 0% in tetralogy of Fallot, 8.6% in atrioventricular canal defect, and 4.1% in complete transposition of the great arteries. Freedom from reoperation at 20 years was 96.5±2.0% and actuarial survival was 94.2±1.3% in ventricular septal defect. Freedom from reoperation at 15 years was 90.5±3.9% in tetralogy of Fallot and 86.6±4.4% in atrioventricular canal defect. Actuarial survival at 15 years was 97.8±1.6% in tetralogy of Fallot, 85.7±3.7% in atrioventricular canal defect, and 89.9±2.2% in complete transposition of the great arteries. Actuarial survival in complete transposition of the great arteries was significantly better in arterial than in atrial switch operations.Conclusions: Total correction of ventricular septal defect, tetralogy of Fallot, atrioventricular canal defect, and complete transposition of the great arteries in infancy was conducted safely, but the incidence of reoperation in late follow-up must be reduced.
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Masuda M, Kado H, Imoto Y, Shiokawa Y, Fukae K, Kanegae Y, et al. Clinical results of mitral valve surgery in children (in Japanese). Jpn J Thorac Surg 1999; 52: 301–6.
Matsumoto T, Kado H, Masuda M, Shiokawa Y, Fukae K, Morita S, et al. Clinical results of mitral valve repair by reconstructing artificial chordae tendineae in children. J Thorac Cardiovasc Surg 1999; 118: 94–8.
Sousa-Uva M, Lacour-Gayet F, Komiya T, Serraf A, Bruniaux J, Touchot A, et al. Surgery for tetralogy of Fallot at less than six months of age. J Thorac Cardiovasc Surg 1994; 107: 1291–300.
Pigula FA, Khalil PN, Mayer JE, del Nido PJ, Jonas RA. Repair of tetralogy of Fallot in neonates and young infants. Circulation 1999; 100 (Suppl II):.
Caspi J, Zalstein E, Zucker N, Applebaum A, Harrison LH, Munfakh NA, et al. Surgical management of tetralogy of Fallot in the first year of life. Ann Thorac Surg 1999; 68: 1344–9.
Knott-Craig CJ, Elkins RC, Lane MM, Holz J, McCue C, Ward KE. A 26-year experience with surgical management of tetralogy of Fallot: risk analysis for mortality or late intervention. Ann Thorac Surg 1998; 66: 506–11.
Jonsson H, Ivert T, Brodin LA. Echocardiographic findings in 83 patients 13–26 years after intracardiac repair of tetralogy of Fallot. Eur Heart J 1995; 16 1255–63.
Meijboom F, Szatmari A, Deckers JW, Utens EM, Roelandt JR, Bos E, et al. Cardiac status and health-related quality of life in the long term after surgical repair of tetralogy of Fallot in infancy and childhood. J Thorac Cardiovasc Surg 1995; 110: 883–91.
Singh GK, Greenberg B, Yap YS, Delany DP, Keeton BR, Monro JL. Right ventricular function and exercise performance late after primary repair of tetralogy of Fallot with the transannular patch in infancy. Am J Cardiol 1998; 81: 1378–83.
Yasui H, Nakamura Y, Kado H, Yonenaga K, Aso T, Sunagawa H, et al. Preservation of the pulmonary valve during intracardiac repair of tetralogy of Fallot. J Cardiovasc Surg 1992; 33: 545–53.
Shiokawa Y, Kado H, Imoto Y, Kanegae Y, Fukae K, Iwaki H, et al. Long-term results of tetralogy of Fallot. Advantage of pulmonary valve preservation (in Japanese). Act Cardiol Paediatr Jpn 2000; 16: 617–5.
Manning PB, Mayer KE, Sanders SP, Coleman EA, Jonas RA, Keane JF, et al. Unique features and prognosis of primum ASD presenting in the first year of life. Circulation 1994; 90 (Suppl) II):.
Giamberti A, Marino B, di Carlo D, Iorio FS, Formigari R, de Zorzi A, et al. Partial atrioventricular canal with congestive heart failure in the first year of life surgical options. Ann Thorac Surg 1996; 62: 151–4.
Yasui H, Nakamura Y, Kado H, Yonenaga K, Shiokawa Y, Fusazaki N, et al. Primary repair of complete atrioventricular canal: recommendation for early primary repair. J Cardiovasc Surg 1990; 31: 498–504.
Ross DA, Nanton M, Gillis DA, Murphy DA. Atrioventricular canal defects: results of repair in the current era. J Card Surg 1991; 6: 367–72.
Hanley FL, Fenton KN, Jonas RA, Mayer JE, Cook NR, Wernovsky G, et al. Surgical repair of complete atrioventricular canal defects in infancy. Twenty-year trend. J Thorac Cardiovasc Surg 1993; 106: 387–97.
Bando K, Terrentine MW, Sun K, Sharp TG, Ensing GJ, Miller AP, et al. Surgical management of complete atrioventricular septal defects: a 20-year experience. J Thorac Cardiovasc Surg 1995; 110: 1543–54.
Tweddell JS, Litwin SB, Berger S, Friedberg DZ, Thomas JP, Frommelt PC, et al. Twenty-year experience with repair of complete atrioventricular septal defects. Ann Thorac Surg 1996; 62: 419–24.
Morris CD, Magilke D, Reller M. Down's syndrome affects results of surgical correction of complete atrioventricular canal. Pediatr Cardiol 1992; 13: 80–4.
Rizzoli G, Mazzucco A, Maizza F, Daliento L, Rubino M, Tursi V, et al. Does Down syndrome affect prognosis of surgically managed atrioventricular canal defects? J Thorac Cardiovasc Surg 1992; 104: 945–53.
Lupinetti FM, Bove EL, Minich LL, Snider AR, Callow LB, Meliones JN, et al. Intermediate-term survival and functional results after arterial repair for transposition of the great arteries. J Thorac Cardiovasc Surg 1992; 103: 421–7.
Yamaguchi M, Hosokawa Y, Imai Y, Kurosawa H, Yasui H, Yagihara T, et al. Early and midterm results of the arterial switch operation for transposition of the great arteries in Japan. J Thorac Cardiovasc Surg 1990; 100: 261–9.
Wernovsky G, Mayer JE, Jonas RA, Hanley FL, Blackstone EH, Kirklin JW, et al. Factors influencing early and late outcome of the arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg 1995; 109: 289–302.
Serraf A, Roux D, Lacour-Gavet F, Touchot A, Bruniauz J, Sousa-Uva M, et al. Reoperation after the arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg 1995; 110: 892–9.
Masuda M, Yasui H. Reoperation after repair of complete transposition of the great arteries (in Japanese). J Jpn Surg Soc 1998; 99: 78–83.
Paillole C, Sidi D, Kachaner J, Planche C, Belot JP, Villain E, et al. Fate of pulmonary artery after anatomic correction of simple transposition of great arteries in newborn infants. Circulation 1988; 78: 870–6.
Kado H, Asoh T, Imoto Y, Shiokawa Y, Yamasaki M, Yasui H. Reoperation for transposition of the great arteries. Midterm results and reoperation after arterial switch operation (in Japanese). J Ann Thorac Surg 1994; 14: 192–7.
Pacifico AD, Stewart RW, Bargeron LM. Repair of transposition of the great arteries with ventricular septal defect by an arterial switch operation. Circulation 1983; 68 (Suppl II):.
Imoto Y, Kado H, Asou T, Shiokawa Y, Miyake Y, Yasuda H, et al. Postoperative pulmonary stenosis after arterial switch operation comparison in 3 methods of pulmonary reconstruction: modified Pacifico, autologous pericardial patch, and equine pericardial patch (in Japanese). Jpn J Thorac Surg 1995; 48: 433–8.
Yasui H, Yonenaga K, Kado H, Nakamura Y, Fusazaki N, Tsuruhara Y, et al. Arterial switch operation for transposition of the great arteries: surgical techniques to avoid complications. J Cardiovasc Surg 1992; 33: 511–7.
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Read at the Fifty-Third Annual Meeting of The Japanese Association for Thoracic Surgery, Panel disussion. Oita, October 25–27, 2000.
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Masuda, M., Kado, H., Kajihara, N. et al. Early and late results of total correction of congenital cardiac anomalies in infancy. Jpn J Thorac Caridovasc Surg 49, 497–503 (2001). https://doi.org/10.1007/BF02919544
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DOI: https://doi.org/10.1007/BF02919544