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Predictores a largo plazo de la dilatación de la raíz aórtica y la regurgitación aórtica después de la operación del

Marcy L Schwartz¹, Kimberlee Gauvreau, Pedro del Nido

¹Department of Cardiology, Children's Hospital, 300 Longwood Avenue, Boston, Mass 02115, USA. Marcy.Schwartz@cardio.chboston.org

|September 15, 2004

Resumen

La dilatación y la regurgitación de la raíz neo-aórtica pueden ocurrir después de la operación de interruptor arterial para la transposición de bucle d de las grandes arterias. La banda previa de la arteria pulmonar y la mayor edad en la cirugía son factores de riesgo para estas complicaciones.

Área de la Ciencia:

Cardiología Pediátrica Cardiología pediátrica.
Cirugía del corazón congénito Cirugía del corazón congénito.
Imágenes cardíacas por imagen.

Sus antecedentes:

La dilatación de la raíz neo-aórtica (ARD) y la regurgitación neo-aórtica (AR) son posibles complicaciones a largo plazo después de la operación de conmutación arterial (ASO) para la transposición de bucle d de las grandes arterias (dTGA).
La identificación de predictores de ARD y AR es crucial para mejorar los resultados de los pacientes después de ASO.

Objetivo del estudio:

Identificar los predictores independientes de la dilatación de la raíz neo-aórtica (ARD) y la regurgitación neo-aórtica (AR) después de la operación de conmutación arterial (ASO) en pacientes con transposición de bucle d de las grandes arterias (dTGA).

Principales métodos:

Análisis retrospectivo de 335 pacientes que se sometieron a ASO para dTGA con el tabique ventricular intacto o VSD antes de 2001.
Criterios de inclusión: al menos un ecocardiograma postoperatorio >1 año después de la ASO, sin procedimiento de conmutación auricular previo.
El análisis de Kaplan-Meier y el modelado de riesgos proporcionales de Cox se utilizaron para identificar los predictores.

Principales resultados:

La probabilidad de estar libre de ARD fue del 51% a los 10 años; la ARD no fue progresiva en el seguimiento tardío.
La banda anterior de la arteria pulmonar (PAB) y el período de tiempo posterior de ASO fueron predictores independientes de ARD.
La edad avanzada en ASO (>1 año), la presencia/reparación de VSD y la PAB previa fueron factores de riesgo para la AR moderada o grave.

Conclusiones:

ARD y AR significativos se desarrollan con el tiempo después de ASO, pero ARD generalmente no es progresiva.
Anterior PAB es un factor de riesgo significativo para ARD.
La edad avanzada en ASO, VSD y PAB anterior son factores de riesgo para AR, lo que requiere un monitoreo cercano.

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