Intermediate-term mortality and cardiac transplantation in infants with single-ventricle lesions: Risk factors and their interaction with shunt type

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Presentation transcript:

Intermediate-term mortality and cardiac transplantation in infants with single-ventricle lesions: Risk factors and their interaction with shunt type James S. Tweddell, MD, Lynn A. Sleeper, ScD, Richard G. Ohye, MD, Ismee A. Williams, MD, MS, Lynn Mahony, MD, Christian Pizarro, MD, Victoria L. Pemberton, RNC, MS, Peter C. Frommelt, MD, Scott M. Bradley, MD, James F. Cnota, MD, Jennifer Hirsch, MD, MS, Paul M. Kirshbom, MD, Jennifer S. Li, MD, MHS, Nancy Pike, RN, PhD, Michael Puchalski, MD, Chitra Ravishankar, MD, Jeffrey P. Jacobs, MD, Peter C. Laussen, MBBS, Brian W. McCrindle, MD, MPH The Journal of Thoracic and Cardiovascular Surgery Volume 144, Issue 1, Pages 152-159.e2 (July 2012) DOI: 10.1016/j.jtcvs.2012.01.016 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Proportion of subjects in each of 3 competing mutually exclusive end states: death, transplant, and alive without transplant for all 549 subjects (solid curves). Dashed curves represent the pointwise 68% (1 standard error) confidence bands based on the parametric fit. The squares and associated error bars represent the nonparametric estimates ± 1 standard error. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 152-159.e2DOI: (10.1016/j.jtcvs.2012.01.016) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Parametric survival curve by anatomic subtype of subjects undergoing RVPAS. B, Parametric survival curve by anatomic subtype of subjects undergoing MBTS. C, Parametric survival curve for higher-risk subjects, showing the impact of OPVR on survival among subjects undergoing the Norwood procedure with MBTS versus RVPAS. D, Parametric survival curve for higher-risk subjects showing the impact of a genetic syndrome on survival among subjects undergoing the Norwood procedure with MBTS versus RVPAS. E, Parametric survival curve for lower-risk subjects, showing the impact of shunt type, SES, and aortic diameter on survival of subjects with HLHS-AA/MA. F, Parametric survival curve for lower-risk subjects, showing the impact of shunt type, SES, and aortic diameter on survival of subjects with HLHS-AS/MS. RVPA, Right ventricle-to-pulmonary artery; SES, socioeconomic status; GA, gestational age; OPVR, obstructed pulmonary venous return; Ao, aorta; diam, diameter; MS, mitral stenosis; MBT, modified Blalock–Taussig; HLHS, hypoplastic left heart syndrome; AA, aortic atresia; MA, mitral atresia. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 152-159.e2DOI: (10.1016/j.jtcvs.2012.01.016) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Predicted probability of freedom from transplant for subjects with differing cardiac anatomy, right ventricle function, and numbers of pre-Norwood surgeries. HLHS, Hypoplastic left heart syndrome; RV, right ventricle; MBTS, modified Blalock–Taussig shunt; RVPAS, right ventricle-to-pulmonary artery shunt; Nwd, Norwood. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 152-159.e2DOI: (10.1016/j.jtcvs.2012.01.016) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions