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Preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart
BACKGROUND: Second-stage palliation with hemi-Fontan or bidirectional Glenn procedures has improved the outcomes of patients treated for single-ventricle heart disease. The aim of this study was to retrospectively analyze risk factors for death after second-stage palliation of single-ventricle heart...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594433/ https://www.ncbi.nlm.nih.gov/pubmed/28893257 http://dx.doi.org/10.1186/s12947-017-0114-7 |
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author | Pająk, Jacek Buczyński, Michał Stanek, Piotr Zalewski, Grzegorz Wites, Marek Szydłowski, Lesław Mazurek, Bogusław Tomkiewicz-Pająk, Lidia |
author_facet | Pająk, Jacek Buczyński, Michał Stanek, Piotr Zalewski, Grzegorz Wites, Marek Szydłowski, Lesław Mazurek, Bogusław Tomkiewicz-Pająk, Lidia |
author_sort | Pająk, Jacek |
collection | PubMed |
description | BACKGROUND: Second-stage palliation with hemi-Fontan or bidirectional Glenn procedures has improved the outcomes of patients treated for single-ventricle heart disease. The aim of this study was to retrospectively analyze risk factors for death after second-stage palliation of single-ventricle heart and to compare therapeutic results achieved with the hemi-Fontan and bidirectional Glenn procedures. MATERIAL AND METHODS: We analyzed 60 patients who had undergone second-stage palliation for single-ventricle heart. Group HF consisted of 23 (38.3%) children who had been operated with the hemi-Fontan method; Group BDG consisted of 37 (61.7%) who had been operated with the bidirectional Glenn method. The analysis focused on 30-day postoperative mortality rates, clinical and echocardiographic data, and early complications. RESULTS: The patients’ ages at the time of repair was 33 ± 11.2 weeks; weight was 6.7 ± 1.2 kg. The most common anatomic subtype was hypoplastic left heart syndrome, in 36 (60%) patients. The early mortality rate was 13.3%. Significant preoperative atrioventricular valve regurgitation, single-ventricle heart dysfunction, pneumonia/sepsis, and arrhythmias were associated with higher mortality rates after second-stage palliation. Multivariate analysis identified significant preoperative single-ventricle heart dysfunction as an independent predictor of early death after second-stage palliation. No differences were found in the analyzed variables after bidirectional Glenn compared with hemi-Fontan procedures. CONCLUSION: Significant preoperative atrioventricular valve regurgitation, arrhythmias and pneumonia/sepsis are closely correlated with mortality in patients with single-ventricle heart after second-stage palliation. Preoperative significant single-ventricle heart dysfunction is an independent mortality predictor in this group of patients. There are no differences in clinical, echocardiographic data, or outcomes in patients treated with the hemi-Fontan compared with bidirectional Glenn procedures. |
format | Online Article Text |
id | pubmed-5594433 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55944332017-09-14 Preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart Pająk, Jacek Buczyński, Michał Stanek, Piotr Zalewski, Grzegorz Wites, Marek Szydłowski, Lesław Mazurek, Bogusław Tomkiewicz-Pająk, Lidia Cardiovasc Ultrasound Research BACKGROUND: Second-stage palliation with hemi-Fontan or bidirectional Glenn procedures has improved the outcomes of patients treated for single-ventricle heart disease. The aim of this study was to retrospectively analyze risk factors for death after second-stage palliation of single-ventricle heart and to compare therapeutic results achieved with the hemi-Fontan and bidirectional Glenn procedures. MATERIAL AND METHODS: We analyzed 60 patients who had undergone second-stage palliation for single-ventricle heart. Group HF consisted of 23 (38.3%) children who had been operated with the hemi-Fontan method; Group BDG consisted of 37 (61.7%) who had been operated with the bidirectional Glenn method. The analysis focused on 30-day postoperative mortality rates, clinical and echocardiographic data, and early complications. RESULTS: The patients’ ages at the time of repair was 33 ± 11.2 weeks; weight was 6.7 ± 1.2 kg. The most common anatomic subtype was hypoplastic left heart syndrome, in 36 (60%) patients. The early mortality rate was 13.3%. Significant preoperative atrioventricular valve regurgitation, single-ventricle heart dysfunction, pneumonia/sepsis, and arrhythmias were associated with higher mortality rates after second-stage palliation. Multivariate analysis identified significant preoperative single-ventricle heart dysfunction as an independent predictor of early death after second-stage palliation. No differences were found in the analyzed variables after bidirectional Glenn compared with hemi-Fontan procedures. CONCLUSION: Significant preoperative atrioventricular valve regurgitation, arrhythmias and pneumonia/sepsis are closely correlated with mortality in patients with single-ventricle heart after second-stage palliation. Preoperative significant single-ventricle heart dysfunction is an independent mortality predictor in this group of patients. There are no differences in clinical, echocardiographic data, or outcomes in patients treated with the hemi-Fontan compared with bidirectional Glenn procedures. BioMed Central 2017-09-11 /pmc/articles/PMC5594433/ /pubmed/28893257 http://dx.doi.org/10.1186/s12947-017-0114-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Pająk, Jacek Buczyński, Michał Stanek, Piotr Zalewski, Grzegorz Wites, Marek Szydłowski, Lesław Mazurek, Bogusław Tomkiewicz-Pająk, Lidia Preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart |
title | Preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart |
title_full | Preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart |
title_fullStr | Preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart |
title_full_unstemmed | Preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart |
title_short | Preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart |
title_sort | preoperative single ventricle function determines early outcome after second-stage palliation of single ventricle heart |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594433/ https://www.ncbi.nlm.nih.gov/pubmed/28893257 http://dx.doi.org/10.1186/s12947-017-0114-7 |
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