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Long-Term Surgical Outcomes in Double Outlet Right Ventricle Based on Detailed Anatomical Sub-Typology
Kunjing Pang1, Keming Yang2, Rong Wang1
1Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Summary
Precise anatomical evaluation and tailored surgery improve outcomes for double outlet right ventricle (DORV) patients. Transposition of the great arteries-type anatomy and palliative procedures are key risk factors for mortality.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Cardiac Anatomy
Background:
- Double outlet right ventricle (DORV) presents significant challenges in pediatric cardiac surgery.
- Long-term outcomes for DORV patients require further investigation.
Purpose of the Study:
- To investigate the mid- to long-term surgical outcomes in a large cohort of double outlet right ventricle patients.
- To identify factors influencing mortality and reintervention rates in DORV.
Main Methods:
- Retrospective review of 1135 DORV patients undergoing surgery between 2001 and 2023.
- Surgery was guided by a refined anatomical sub-typology.
- Primary endpoint: cardiac mortality; Secondary endpoint: unplanned surgical reintervention.
Main Results:
- Overall survival rates at 5, 10, and 15 years were 96.3%, 93.0%, and 92.7% respectively.
- Second endpoint-free survival rates at 5, 10, and 15 years were 95.2%, 89.5%, and 82.1% respectively.
- Transposition of the great arteries-type (TGA-type) anatomy and palliative procedures were independently associated with increased mortality.
Conclusions:
- Tailored surgical approaches based on precise anatomical evaluation are crucial for optimal DORV outcomes.
- TGA-type anatomy and palliative procedures are significant risk predictors for adverse outcomes in DORV patients.
