{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:00:14Z","timestamp":1787497214600,"version":"build-2736575974"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T00:00:00Z","timestamp":1627862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T00:00:00Z","timestamp":1627862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Left ventricular outflow tract obstruction is an important complication after interrupted aortic arch repair and subsequent interventions may adversely affect survival. Identification of patients at risk for obstruction is important to facilitate clinical decision-making and monitoring during follow-up. The aim of this review is to summarize reported risk factors for left ventricular outflow tract obstruction after corrective surgery for interrupted aortic arch. A systematic search of the literature was performed across the PubMed and EMBASE databases. Studies that reported echocardiographic and\/or clinical predictors for left ventricular outflow tract obstruction in infants that underwent biventricular repair of interrupted aortic arch were included. From the 44 potentially relevant studies, eight studies met the inclusion criteria. Postoperative left ventricular outflow tract obstruction requiring an intervention was common, with an incidence ranging between 14 and 38%. Manifestation of postoperative left ventricular outflow tract obstruction was associated with a smaller pre-operative size of the aortic root (sinus of Valsalva), sinotubular junction, and aortic annulus. Anatomic and surgical risk factors for left ventricular outflow tract obstruction were the presence of an aberrant right subclavian artery, use of a pulmonary homograft or polytetrafluoroethylene interposition graft for aortic arch repair, and the presence of a small- or medium-sized ventricular septal defect. In patients with a borderline left ventricular outflow tract that undergo a primary repair, these (pre-) operative predictors can provide guidance for optimal surgical decision-making and for close monitoring during follow-up of patients at increased risk for developing left ventricular outflow tract obstruction after corrective surgery.<\/jats:p>","DOI":"10.1007\/s00246-021-02689-9","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T01:02:49Z","timestamp":1627866169000},"page":"1665-1675","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Predictors of Left Ventricular Outflow Tract Obstruction After Primary Interrupted Aortic Arch Repair"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6782-9644","authenticated-orcid":false,"given":"Nina A.","family":"Korsuize","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"van Wijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Haas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9625-5969","authenticated-orcid":false,"given":"Heynric B.","family":"Grotenhuis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,2]]},"reference":[{"issue":"3","key":"2689_CR1","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/S0003-4975(99)01280-1","volume":"69","author":"CL Backer","year":"2000","unstructured":"Backer CL, Mavroudis C (2000) Congenital Heart Surgery Nomenclature and Database Project: patent ductus arteriosus, coarctation of the aorta, interrupted aortic arch. Ann Thorac Surg 69(3):298\u2013307. https:\/\/doi.org\/10.1016\/S0003-4975(99)01280-1","journal-title":"Ann Thorac Surg"},{"issue":"8","key":"2689_CR2","doi-asserted-by":"publisher","first-page":"S315","DOI":"10.1097\/PCC.0000000000000826","volume":"17","author":"AK Kaza","year":"2016","unstructured":"Kaza AK, Thiagarajan RR (2016) Left ventricular outflow tract obstruction: coarctation of the aorta, interrupted aortic arch, and borderline left ventricle. Pediatr Crit Care Med 17(8):S315\u2013S317. https:\/\/doi.org\/10.1097\/PCC.0000000000000826","journal-title":"Pediatr Crit Care Med"},{"issue":"3","key":"2689_CR3","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/0002-8703(59)90157-7","volume":"58","author":"GC Celoria","year":"1977","unstructured":"Celoria GC, Patton RB (1977) Congenital absence of the aortic arch. Am Heart J 58(3):407\u2013413. https:\/\/doi.org\/10.1016\/0002-8703(59)90157-7","journal-title":"Am Heart J"},{"issue":"4","key":"2689_CR4","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/s0002-9149(77)80168-9","volume":"39","author":"RM Freedom","year":"1977","unstructured":"Freedom RM, Bain HH, Esplugas E, Dische R, Rowe RD (1977) Ventricular septal defect in interruption of aortic arch. Am J Cardiol 39(4):572\u2013582. https:\/\/doi.org\/10.1016\/s0002-9149(77)80168-9","journal-title":"Am J Cardiol"},{"issue":"2","key":"2689_CR5","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/0002-9149(71)90259-1","volume":"27","author":"R Van Praagh","year":"1971","unstructured":"Van Praagh R, Bernhard WF, Rosenthal A, Parisi LF, Fyler DC (1971) Interrupted aortic arch: surgical treatment. Am J Cardiol 27(2):200\u2013211. https:\/\/doi.org\/10.1016\/0002-9149(71)90259-1","journal-title":"Am J Cardiol"},{"key":"2689_CR6","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/B978-1-4557-0760-7.00046-2","volume-title":"Critical heart disease in infants and children","author":"AC Fiore","year":"2019","unstructured":"Fiore AC, Peterson RE, Huddleston CB (2019) Repair of interrupted aortic arch with ventricular septal defect. In: Ungerleider RM, Meliones JN, Nelson McMillan K, Cooper DS, Jacobs JP (eds) Critical heart disease in infants and children, 3rd edn. Elsevier, Philadelphia, pp 565\u2013571.e1","edition":"3"},{"key":"2689_CR7","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/978-3-642-24169-7_3","volume-title":"Surgical management of congenital heart disease I: complex transposition of great arteries, right and left ventricular outflow tract obstruction, Ebstein\u2019s anomaly\u2014a video manual","author":"V Hraska","year":"2012","unstructured":"Hraska V, Murin P (2012) Left ventricular outflow tract anomalies. In: Hra\u0161ka V, Mur\u00edn P (eds) Surgical management of congenital heart disease I: complex transposition of great arteries, right and left ventricular outflow tract obstruction, Ebstein\u2019s anomaly\u2014a video manual. Springer, Berlin, pp 93\u2013150"},{"key":"2689_CR8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1053\/j.pcsu.2019.02.004","volume":"22","author":"KW Riggs","year":"2019","unstructured":"Riggs KW, Tweddell JS (2019) How small is too small? Decision-making and management of the small aortic root in the setting of interrupted aortic arch. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 22:21\u201326. https:\/\/doi.org\/10.1053\/j.pcsu.2019.02.004","journal-title":"Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu"},{"key":"2689_CR9","first-page":"119","volume-title":"Surgical management of congenital heart disease II: single ventricle and hypoplastic left heart syndrome, aortic arch anomalies, septal defects and anomalies in pulmonary venous return, anomalies of thoracic arteries and veins\u2014a video manual","author":"V Hra\u0161ka","year":"2015","unstructured":"Hra\u0161ka V, Mur\u00edn P (2015) Interruption of the Aortic Arch. In: Hra\u0161ka V, Mur\u00edn P (eds) Surgical management of congenital heart disease II: single ventricle and hypoplastic left heart syndrome, aortic arch anomalies, septal defects and anomalies in pulmonary venous return, anomalies of thoracic arteries and veins\u2014a video manual. Springer, Berlin, pp 119\u2013137"},{"issue":"4","key":"2689_CR10","doi-asserted-by":"publisher","first-page":"280","DOI":"10.7326\/0003-4819-158-4-201302190-00009","volume":"158","author":"JA Hayden","year":"2013","unstructured":"Hayden JA, van der Windt DA, Cartwright JL, C\u00f4t\u00e9 P, Bombardier C (2013) Assessing bias in studies of prognostic factors. Ann Intern Med 158(4):280\u2013286. https:\/\/doi.org\/10.7326\/0003-4819-158-4-201302190-00009","journal-title":"Ann Intern Med"},{"issue":"7","key":"2689_CR11","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1136\/bmj.b2535","volume":"6","author":"D Moher","year":"2009","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097. https:\/\/doi.org\/10.1136\/bmj.b2535","journal-title":"PLoS Med"},{"issue":"7","key":"2689_CR12","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1016\/0735-1097(93)90785-y","volume":"22","author":"T Geva","year":"1993","unstructured":"Geva T, Hornberger LK, Sanders SP, Jonas RA, Ott DA, Colan SD (1993) Echocardiographic predictors of left ventricular outflow tract obstruction after repair of interrupted aortic arch. J Am Coll Cardiol 22(7):1953\u20131960. https:\/\/doi.org\/10.1016\/0735-1097(93)90785-y","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"2689_CR13","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1016\/j.jtcvs.2010.07.067","volume":"140","author":"A Jegatheeswaran","year":"2010","unstructured":"Jegatheeswaran A, McCrindle BW, Blackstone EH et al (2010) Persistent risk of subsequent procedures and mortality in patients after interrupted aortic arch repair: a Congenital Heart Surgeons\u2019 Society study. J Thorac Cardiovasc Surg 140(5):1059\u20131075.e2. https:\/\/doi.org\/10.1016\/j.jtcvs.2010.07.067","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"2","key":"2689_CR14","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/j.athoracsur.2013.04.027","volume":"96","author":"PC Chen","year":"2013","unstructured":"Chen PC, Cubberley AT, Reyes K et al (2013) Predictors of reintervention after repair of interrupted aortic arch with ventricular septal defect. Ann Thorac Surg 96(2):621\u2013628. https:\/\/doi.org\/10.1016\/j.athoracsur.2013.04.027","journal-title":"Ann Thorac Surg"},{"issue":"3","key":"2689_CR15","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1111\/chd.12599","volume":"13","author":"G Abarbanell","year":"2018","unstructured":"Abarbanell G, Border WL, Schlosser B, Morrow G, Kelleman M, Sachdeva R (2018) Preoperative echocardiographic measures in interrupted aortic arch: which ones best predict surgical approach and outcome? Congenit Heart Dis 13(3):476\u2013482. https:\/\/doi.org\/10.1111\/chd.12599","journal-title":"Congenit Heart Dis"},{"issue":"2","key":"2689_CR16","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1016\/j.athoracsur.2010.04.065","volume":"90","author":"Y Hirata","year":"2010","unstructured":"Hirata Y, Quaegebeur JM, Mosca RS, Takayama H, Chen JM (2010) Impact of aortic annular size on rate of reoperation for left ventricular outflow tract obstruction after repair of interrupted aortic arch and ventricular septal defect. Ann Thorac Surg 90(2):588\u2013592. https:\/\/doi.org\/10.1016\/j.athoracsur.2010.04.065","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"2689_CR17","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/s0002-9149(98)00362-2","volume":"82","author":"HD Apfel","year":"1998","unstructured":"Apfel HD, Levenbraun J, Quaegebeur JM, Allan LD (1998) Usefulness of preoperative echocardiography in predicting left ventricular outflow obstruction after primary repair of interrupted aortic arch with ventricular septal defect. Am J Cardiol 82(4):470\u2013473. https:\/\/doi.org\/10.1016\/s0002-9149(98)00362-2","journal-title":"Am J Cardiol"},{"issue":"4","key":"2689_CR18","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1016\/j.jtcvs.2005.11.038","volume":"131","author":"T Suzuki","year":"2006","unstructured":"Suzuki T, Ohye RG, Devaney EJ et al (2006) Selective management of the left ventricular outflow tract for repair of interrupted aortic arch with ventricular septal defect: management of left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg 131(4):779\u2013784. https:\/\/doi.org\/10.1016\/j.jtcvs.2005.11.038","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"9","key":"2689_CR19","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1016\/s0002-9149(00)01149-8","volume":"86","author":"MM Salem","year":"2000","unstructured":"Salem MM, Starnes VA, Wells WJ et al (2000) Predictors of left ventricular outflow obstruction following single-stage repair of interrupted aortic arch and ventricular septal defect. Am J Cardiol 86(9):1044\u20131047. https:\/\/doi.org\/10.1016\/s0002-9149(00)01149-8","journal-title":"Am J Cardiol"},{"issue":"10","key":"2689_CR20","first-page":"1071","volume":"69","author":"FE Harrell Jr","year":"1985","unstructured":"Harrell FE Jr, Lee KL, Matchar DB, Reichert TA (1985) Regression models for prognostic prediction: advantages, problems, and suggested solutions. Cancer Treat Rep 69(10):1071\u20131077","journal-title":"Cancer Treat Rep"},{"issue":"4","key":"2689_CR21","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/j.ejcts.2008.12.044","volume":"35","author":"PK Mishra","year":"2009","unstructured":"Mishra PK (2009) Management strategies for interrupted aortic arch with associated anomalies. Eur J Cardiothorac Surg 35(4):569\u2013576. https:\/\/doi.org\/10.1016\/j.ejcts.2008.12.044","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-021-02689-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00246-021-02689-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-021-02689-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T11:10:58Z","timestamp":1635592258000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00246-021-02689-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,2]]},"references-count":21,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2689"],"URL":"https:\/\/doi.org\/10.1007\/s00246-021-02689-9","relation":{},"ISSN":["0172-0643","1432-1971"],"issn-type":[{"value":"0172-0643","type":"print"},{"value":"1432-1971","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,2]]},"assertion":[{"value":"1 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}