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Long-term outcome after right ventricle to pulmonary artery conduit surgery and reintervention

Skoglund, Kristofer; Svensson, Gunnar; Thilén, Ulf LU ; Dellborg, Mikael and Eriksson, Peter (2017) In Scandinavian Cardiovascular Journal1997-01-01+01:00 p.1-8
Abstract

Background. Reconstruction of the right ventricular outflow tract with a conduit is an established surgical procedure in congenital heart disease and reinterventions are common. Objective. An increasing number of patients have a conduit, but there are few population-based studies of long-term outcomes after conduit surgery, reoperations, and transcatheter pulmonary valve replacement. Methods. In April 2015, all adult patients with a conduit were identified in the Swedish National Registry for Congenital Heart Disease (SWEDCON). Data on patients who died before age of 16 years are not included in the registry and thus not included in the study. Results. We found 574 patients with a mean age 36.1 years. The largest proportion had... (More)

Background. Reconstruction of the right ventricular outflow tract with a conduit is an established surgical procedure in congenital heart disease and reinterventions are common. Objective. An increasing number of patients have a conduit, but there are few population-based studies of long-term outcomes after conduit surgery, reoperations, and transcatheter pulmonary valve replacement. Methods. In April 2015, all adult patients with a conduit were identified in the Swedish National Registry for Congenital Heart Disease (SWEDCON). Data on patients who died before age of 16 years are not included in the registry and thus not included in the study. Results. We found 574 patients with a mean age 36.1 years. The largest proportion had tetralogy of Fallot (45%). In total there were 762 operations and 50 transcatheter pulmonary valve replacements. Mean age at first conduit operation was 20.2 years. Long-term survival up to 48 years including perioperative mortality (<1%) was 93% at 20 years. The most common cause of death was cardiac-related. Higher age at first conduit operation was associated with increased mortality risk. Reintervention-free survival was 77% and 54% at 10 and 20 years, respectively. Conduit reinterventions were common. Ten-year reintervention-free survival after first conduit reintervention (n = 176) was significantly lower than after first conduit operation (70% vs 77% p = .04). Higher age at first conduit operation was associated with a reduced risk of reintervention, whereas male sex and complex malformations were associated with increased risk of reintervention. Conclusions. The mortality of repeated conduit reinterventions is low. The need for reintervention of conduits is considerable, and reintervention-free survival after the first conduit reintervention is poorer than after first conduit implantation. The findings in this study only applies for patients reaching 16 years of age.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
conduit, Congenital heart disease, mortality, reintervention, transcatheter pulmonary valve replacement
in
Scandinavian Cardiovascular Journal1997-01-01+01:00
pages
8 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85021196484
  • wos:000416503800007
ISSN
1401-7431
DOI
10.1080/14017431.2017.1343492
language
English
LU publication?
yes
id
524fef0f-3518-46a2-adc6-c873b840427c
date added to LUP
2017-08-10 12:03:11
date last changed
2018-01-16 13:22:34
@article{524fef0f-3518-46a2-adc6-c873b840427c,
  abstract     = {<p>Background. Reconstruction of the right ventricular outflow tract with a conduit is an established surgical procedure in congenital heart disease and reinterventions are common. Objective. An increasing number of patients have a conduit, but there are few population-based studies of long-term outcomes after conduit surgery, reoperations, and transcatheter pulmonary valve replacement. Methods. In April 2015, all adult patients with a conduit were identified in the Swedish National Registry for Congenital Heart Disease (SWEDCON). Data on patients who died before age of 16 years are not included in the registry and thus not included in the study. Results. We found 574 patients with a mean age 36.1 years. The largest proportion had tetralogy of Fallot (45%). In total there were 762 operations and 50 transcatheter pulmonary valve replacements. Mean age at first conduit operation was 20.2 years. Long-term survival up to 48 years including perioperative mortality (&lt;1%) was 93% at 20 years. The most common cause of death was cardiac-related. Higher age at first conduit operation was associated with increased mortality risk. Reintervention-free survival was 77% and 54% at 10 and 20 years, respectively. Conduit reinterventions were common. Ten-year reintervention-free survival after first conduit reintervention (n = 176) was significantly lower than after first conduit operation (70% vs 77% p = .04). Higher age at first conduit operation was associated with a reduced risk of reintervention, whereas male sex and complex malformations were associated with increased risk of reintervention. Conclusions. The mortality of repeated conduit reinterventions is low. The need for reintervention of conduits is considerable, and reintervention-free survival after the first conduit reintervention is poorer than after first conduit implantation. The findings in this study only applies for patients reaching 16 years of age.</p>},
  author       = {Skoglund, Kristofer and Svensson, Gunnar and Thilén, Ulf and Dellborg, Mikael and Eriksson, Peter},
  issn         = {1401-7431},
  keyword      = {conduit,Congenital heart disease,mortality,reintervention,transcatheter pulmonary valve replacement},
  language     = {eng},
  month        = {06},
  pages        = {1--8},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Cardiovascular Journal1997-01-01+01:00},
  title        = {Long-term outcome after right ventricle to pulmonary artery conduit surgery and reintervention},
  url          = {http://dx.doi.org/10.1080/14017431.2017.1343492},
  year         = {2017},
}