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Hospital Outcomes Among Infants With Interrupted Aortic Arch With Simple and Complex Associated Heart Defects.

Aura Andrea Sanchez Mejia1, Neil Cambronero2, Deepa Dongarwar3

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine Houston, Texas.

The American Journal of Cardiology
|January 2, 2022
PubMed
Summary
This summary is machine-generated.

Hospital outcomes for infants with interrupted aortic arch (IAA) show complex lesions increase mortality. Associated genetic conditions and anomalies also elevate risks, while 22q11.2 deletion syndrome increases complications.

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Medical Outcomes Research

Background:

  • Interrupted aortic arch (IAA) is a critical congenital heart defect.
  • Limited multi-institutional data exists on current hospital outcomes for IAA repair.
  • Understanding factors influencing mortality and complications is crucial for improving patient care.

Purpose of the Study:

  • To analyze hospital outcomes of infants undergoing interrupted aortic arch repair.
  • To identify factors associated with hospital mortality and complications.
  • To evaluate the impact of 22q11.2 deletion syndrome on outcomes.

Main Methods:

  • Utilized the Pediatric Health Information System database (2004-2019).
  • Classified infants into simple or complex IAA based on associated heart defects.
  • Employed mixed logistic regression to analyze mortality and complication factors, accounting for hospital clustering.

Main Results:

  • Overall mortality was higher in complex IAA cases (11.7%) compared to simple IAA (4.4%).
  • Factors associated with mortality included low birth weight, non-22q11.2del genetic conditions, and gastrointestinal anomalies in simple IAA.
  • 22q11.2 deletion syndrome was linked to increased sepsis and gastrostomy tube placement in simple IAA, and gastrostomy tube placement in complex IAA.

Conclusions:

  • Complex cardiac lesions significantly increase mortality risk following interrupted aortic arch repair.
  • Extracardiac congenital anomalies and non-22q11.2del genetic conditions are associated with elevated mortality.
  • 22q11.2 deletion syndrome is a significant risk factor for hospital complications in infants with IAA.