Abstract
nosed with TA and normally related great arteries were enrolled from 34 institutions at age < 3 months. At initial presentation, antegrade PBF was absent in 17%, restricted in 52% and unrestricted in 31%. Among infants with surgical intervention (n1⁄4302), index procedures included mBT (n1⁄4189, 62%), PAB ( n1⁄450, 17%) or superior cavopulmonary connection (SCPC; n1⁄463, 21%. Parametric multiphase risk-adjusted models were used to analyze competing outcomes. RESULTS: Risk-adjusted 1-year survival was lower after mBT (90%) versus PAB (97%) or SCPC (97%) (p1⁄4.04). Post-mBT survival was significantly lower if the ducts remained open after the procedure (n1⁄47; 97% vs. 76%;p1⁄4.02) Poor post-mBT survival was also associated with a lower immediate post-procedure (prior to extubation) oxygen saturation (figure). Additionally, anmBTorigin from the subclavian artery trended toward worse survival than an origin from the innominate artery (IA) (87% vs. 94%; p1⁄4.1). At the time of mBT, pulmonary trunk (PT) intervention with either PAB (n1⁄44) or closure (n1⁄421) was associated with reduced 6-year survival (60% versus 93% without, P1⁄4.02), that persisted beyond subsequent conversion to a SCPC (figure). When mBT shunt originated from the IA, together with ductus ligation and in absence of PT intervention, risk-adjusted survival was similar to that of pulmonary artery banding or direct SCPC (figure). CONCLUSION: TA patients palliated with mBT shunt are a highrisk subgroup. A shunt origin from the IA, ductus ligation in the absence of PT intervention and post-mBT oxygen saturation between 80%-85% may help mitigate the associated risks. Although PT intervention at the time of mBT was associated with a particularly high risk of death after SCPC, themechanisms behind this increased risk are not completely understood. Canadian Society for Atherosclerosis, Thrombosis and Vascular Biology (CSATVB) Highlighted Poster ASO HIGHLIGHTED POSTER SESSION Monday, October 27, 2014
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