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Published on: May 11, 2018
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.
Objectives:
Long-term surgical outcomes for double outlet right ventricle (DORV) continue to pose challenges for most paediatric cardiac centres. This study aimed to investigate the mid- to long-term outcomes of a large cohort of DORV patients.
Methods:
DORV patients who underwent surgery guided by a refined anatomical sub-typology in our centre between August 2001 and December 2023 were retrospectively reviewed. The primary end-point was cardiac mortality and the secondary end-point was unplanned surgical reintervention.
Results:
A total of 1135 patients were included in the study. Among them, 824 patients (72.6%) underwent biventricular repair, 258 (22.7%) received single-ventricle procedures, and 53 (4.7%) underwent palliative surgeries. The median age at surgery was 25.0 months [IQR: 9.0-72.0]. In-hospital deaths occurred in 14 cases (1.2%). Over a mean follow-up period of 8.9 years, the estimated overall survival rates at 5, 10, and 15 years were 96.3% [95% CI, 95.1-97.5], 93.0% [95% CI, 91.6-95.2], and 92.7% [95% CI, 87.7-96.9], respectively. Second end-point-free survival rates at the same time points were 95.2% [95% CI, 94.8-95.7], 89.5% [95% CI, 88.7-90.3], and 82.1% [95% CI, 80.7-83.5], respectively. Transposition of the great arteries-type (TGA-type) anatomy and palliative procedures were independently associated with increased mortality.
Conclusions:
Optimal outcomes in DORV can be achieved through precise anatomical evaluation and tailored surgery. TGA-type anatomy and palliative procedure were key risk predictors.
