Objective: to identify the most significant predictors of coronary events in the long-term after the arterial switch operation.
Material and methods. The analysis of the structure, frequency and causes of coronary events in the late period was carried out among 248 patients with transposition of the great arteries undergoing the arterial switch operation. We analyzed the results of clinical and instrumental examination, obtained during the dynamic observation of these patients. A multiple statistical analysis was applied for estimate the isolation and combination influence an each predictors in the long-term period and to determine the most significant perioperative risk factors for the development of this complication.
Results. Coronarу complications in the long-term period after the arterial switch operation were in 35 (14.1%) patients. As a result of multiple analysis, statistically significant predictors for the development of coronary events were: the type of anatomy of the coronary arteries (p=0.02) and the great arteries (p=0.015), the diameter of the ventricular septal defect (p=0.003), the duration of the aortic cross-clamping (p=0.018), the value of arteriovenous desaturation before surgery (p=0.046), the development of hepatic failure after switch operation (p<0.001).
Conclusion. The identified predictors determine the necessary for an integrated approach to dynamic observation, correction the
strategy of cardiology, surgery, anesthesiology and perfusiology for improve the results of the treatment of patients with this pathology
in order to reduce the risk of coronary events in the long-term postoperative period.
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About the authors
- Inessa E. Nefedova, Cand. Med. Sc., Head of Department; orcid.org/0000-0002-9221-051X
David O. Berishvili, Dr. Med. Sc., Head of Department; orcid.org/0000-0001-7379-345X
Vera V. Astakhova, Junior Researcher; orcid.org/0000-0001-9940-4440
Elena A. Andreeva, Perfusionist; orcid.org/0000-0002-3488-4751