Surgical management of aortopulmonary window associated with interrupted aortic arch: A Congenital Heart Surgeons Society study Igor E. Konstantinov,

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Presentation transcript:

Surgical management of aortopulmonary window associated with interrupted aortic arch: A Congenital Heart Surgeons Society study Igor E. Konstantinov, MD, PhD, Tara Karamlou, MD, William G. Williams, MD, Jan M. Quaegebeur, MD, Pedro J. del Nido, MD, Thomas L. Spray, MD, Christopher A. Caldarone, MD, Eugene H. Blackstone, MD, Brian W. McCrindle, MD, MPH The Journal of Thoracic and Cardiovascular Surgery Volume 131, Issue 5, Pages 1136-1141.e2 (May 2006) DOI: 10.1016/j.jtcvs.2005.03.051 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Morphologic subtypes of APW in IAA. Number of patients in each category (numbers in parentheses). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1136-1141.e2DOI: (10.1016/j.jtcvs.2005.03.051) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Time-related freedom from mortality in 20 neonates with APW and IAA was characterized by an early hazard phase. All patients began at the time of initial admission to a Congenital Heart Surgeons Society member institution. Parametric point estimates (solid lines); 70% confidence interval (dashed lines); nonparametric estimates (circles with error bars); number of patients at risk (numbers in parentheses). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1136-1141.e2DOI: (10.1016/j.jtcvs.2005.03.051) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Competing risk analysis estimated that 5 years after definitive repair, 51% underwent initial arch reintervention, 6% underwent initial pulmonary artery reintervention, and 43% were alive without further intervention. No deaths occurred without subsequent reintervention. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1136-1141.e2DOI: (10.1016/j.jtcvs.2005.03.051) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Time-related reintervention for arch obstruction in 19 neonates with APW and IAA was characterized by a steep early hazard phase. All patients began at the time of initial repair of IAA, and therefore 1 patient who died without intervention is not included in this analysis. Reintervention was required in 10 patients. Freedom from aortic reintervention was 56% at 1 year, 48% at 5 years, and 46% at 10 years. Parametric point estimates (solid lines); 70% confidence interval (dashed lines); nonparametric estimates (circles with error bars); number of patients at risk (numbers in parentheses). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1136-1141.e2DOI: (10.1016/j.jtcvs.2005.03.051) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 (Appendix) Overall time-related freedom from reintervention for pulmonary artery obstruction after repair of APW and IAA in 19 neonates. Five patients underwent reintervention after single-stage repair in infancy. In 3 patients, pulmonary artery reintervention occurred concomitant with or after aortic arch reintervention. Overall freedom from reintervention was 78% at 1 year, 75% at 5 years, and 72% at 10 years. Parametric point estimates (solid lines); 70% confidence interval (dashed lines); nonparametric estimates (circles with error bars); number of patients at risk (numbers in parentheses). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1136-1141.e2DOI: (10.1016/j.jtcvs.2005.03.051) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions