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Long-Term Outcome of Arterial Switch Operation Conversion After Failed Senning/Mustard Procedure  Takuya Maeda, MD, Takahiko Sakamoto, MD, Mitsugi Nagashima,

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Presentation on theme: "Long-Term Outcome of Arterial Switch Operation Conversion After Failed Senning/Mustard Procedure  Takuya Maeda, MD, Takahiko Sakamoto, MD, Mitsugi Nagashima,"— Presentation transcript:

1 Long-Term Outcome of Arterial Switch Operation Conversion After Failed Senning/Mustard Procedure 
Takuya Maeda, MD, Takahiko Sakamoto, MD, Mitsugi Nagashima, MD, Takeshi Hiramatsu, MD, Kenji Yamazaki, MD  The Annals of Thoracic Surgery  Volume 102, Issue 5, Pages (November 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Preparatory pulmonary artery banding (PAB) for left ventricular (LV) training. All but 1 patient (non-PAB) had undergone PAB for LV training before arterial switch operation (ASO) conversion. PAB was performed through a left thoracotomy while LV pressure was monitored. Four of 8 patients required the second additional PAB before ASO conversion. The median LV pressure ratio for right ventricular pressure (LVp/RVp) improved from 0.41 to 0.93 after ASO conversion. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 The actuarial survival rate after arterial switch operation (ASO) conversion was 76.1% at both 10 and 20 years. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Clinical status at the last follow-up after arterial switch operation (ASO). (Upper panels) Long-term survivors revealed good New York Heart Association (NYHA) class, and (lower panels) the postoperative tricuspid valve regurgitation (TR) values were remarkably improved. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Follow-up data after arterial switch operation (ASO) conversion (Conv.). (A) Improvements were shown in the cardiothoracic ratio (CTR) and QRS duration. The mean brain natriuretic peptide (BNP) level was also low after ASO conversion. (B) Changes in cardiac catheterization data for right ventricular end-diastolic volume (RVEDV), right ventricular ejection fraction (RVEF), left ventricular end diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) are shown for survivors after pulmonary artery banding (PAB). (C) A temporary decrease occurred in LVEF after PAB, including nonsurvivors. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

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