Prognostic Analysis of One-stage Radical Resection of Interruption of Aortic Arch with Ventricular Septal Defect in Infants: 11-year single-center experience

Abstract

Abstract Background To analyze the risk factors of death and aortic stenosis (AS) in infants with interruption of aortic arch (IAA) and ventricular septal defect (VSD) after one-stage radical resection. Methods A retrospective analysis was performed on 152 children with IAA and VSD from January 2006 to January 2017 who had undergone one-stage radical resection, including 95 cases of type A and 57 cases of type B. Cox proportional hazards regression model was used to analyze the risk factors for mortality and AS after surgery, the overall survival rate was analyzed by the Kaplan-Meier method, and the survival curve was drawn by GraphPad Prism 8 software. Results 22 cases (14.47%) died, 27 cases (17.76%) developed AS. The 1-month, 3-month, 6-month, 1-year, 3-year, and 5-year survival rates were 85.53%, 85.53%, 85.53%, 84.21%, 78.95% and 75.66%, respectively. Low age (P = 0.004), low body weight (P = 0.003), large ratio of VSD diameter/aortic diameter (VSD/AO) (P = 0.044), long duration of cardiopulmonary bypass (P = 0.038), and left ventricular outflow tract obstruction (LVOTO) (P = 0.015) were independent risk factors for postoperative death. The surgical period (from January 2006 to December 2011) (P = 0.046) and the addition of pericardial anastomosis to the anterior aortic wall (P = 0.021) were independent risk factors for postoperative AS. Conclusions Children with low age, low body weight, large ratio of VSD/AO, long duration of cardiopulmonary bypass, LVOTO, the surgical period (from January 2006 to December 2011) and pericardial anastomosis with anterior aortic wall have poor prognosis.