ニイナミ　ヒロシ   Niinami Hiroshi   新浪　博    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Favorable long-term outcomes in hospital survivors of a neonatal arterial switch operation.
掲載誌名	正式名：JTCVS open 略　 称：JTCVS Open ISSNコード：26662736/26662736
掲載区分	国外
巻・号・頁	13,pp.260-270
著者・共著者	Nakayama Yuki†, Shinkawa Takeshi, Shimada Masatoshi, Okugi Satoshi, Niinami Hiroshi
発行年月	2023/02/03
概要	OBJECTIVES:To assess long-term survival and reoperation-free survival after the arterial switch operation (ASO) and analyze the outcomes of reoperations after hospital discharge.METHODS:This was a single-institution retrospective study of 476 hospital survivors of ASO since August 1982. Preoperative diagnoses included 286 transpositions of the great arteries with intact septum, 143 transpositions with ventricular septal defect, and 47 double outlet right ventricles. There were 236 neonatal ASOs, 30 aortic arch repairs, 22 concomitant left ventricular outflow tract obstruction reliefs, 16 preoperative mild pulmonary regurgitations, and 13 intramural coronary arteries.RESULTS:During a median follow-up of 21.1 years (range, 0.1-39.2 years), 25 late deaths (5.3%) and 91 reoperations in 69 patients (14.5%) were noted. The reoperations included 44 left-sided reoperations in 34 patients (7.1%), 35 right-sided reoperations in 30 patients (6.3%), and 12 other reoperations in 12 patients (2.5%). Among the 69 patients who underwent reoperation, those with left-sided reoperations had lower survival at 15 years after reoperation compared to those with non-left-sided reoperations (91.2% vs 100%; P = .015; log-rank, 5.9). Multivariable analysis identified non-neonatal ASO, preoperative pulmonary regurgitation, intramural coronary artery, aortic arch repair, and concomitant left ventricular outflow tract obstruction relief as risk factors for left-sided reoperations. Reoperation-free survival was significantly higher in neonatal ASO compared with non-neonatal ASO (89.2% vs 75.2% at 20 years; P < .001; log-rank, 13.4).CONCLUSIONS:Hospital survivors of neonatal ASO had favorable long-term outcomes.
DOI	10.1016/j.xjon.2023.01.016
PMID	37063155