2. Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Abstract:
Fig. A is a receiver operating characteristic (ROC) curve for geometric orifice area index (GOAI) and mortality within 2 years following systemic atrioventricular valve replacement (SAVVR). Cutoff point of GOAI was 6.44 (area under curve was 0.718, P = 0.034). Therefore, GOAI >6.0 was defined as “oversized prosthesis” in this study. Fig. B is scatterplot of GOAI vs body surface area (BSA) in all patients (Fig. B-1) and in patients who underwent SAVVR before or at the time of bidirectional cavopulmonary shunt (BCPS) (Fig. B-2). Open green circles represent living patients and open red triangle represents dead patients. Multivariate analysis indicated GOAI >6.0 (oversized prosthesis) (P = 0.001; hazard ratio, 14.5), BSA < 0.28 m2 (P = 0.007; hazard ratio, 31.1), preoperative inotropic support (P < 0.001; hazard ratio, 24.5), primary SAVVR (P = 0.044; hazard ratio, 6.1), and intra- or postoperative extracorporeal membrane oxygenation (ECMO) (P < 0.001; hazard ratio, 53.2) were risk factors for mortality. BCPS, bidirectional cavopulmonary shunt; BSA, body surface area; ECMO, extracorporeal membrane oxygenation; GOAI, geometric orifice area index; ROC, receiver operating characteristic; SAVVR, systemic atrioventricular valve replacement
