Academic Journal
Does leaving native antegrade pulmonary blood flow at the time of the superior cavopulmonary connection impact long-term outcomes after the Fontan?Central MessagePerspective
| العنوان: | Does leaving native antegrade pulmonary blood flow at the time of the superior cavopulmonary connection impact long-term outcomes after the Fontan?Central MessagePerspective |
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| المؤلفون: | Hannah Davidson, MBBS, Diana Zannino, MSc, Yves d’Udekem, MD, PhD, Rachael Cordina, MBBS, PhD, FRACP, Yishay Orr, MBBS, PhD, FRACS, Igor E. Konstantinov, MD, PhD, FRACS, Robert Weintraub, MBBS, FRACP, Gavin Wheaton, MBBS, FRACP, Jelena Saundankar, MBBS, FRACP, Gananjay Salve, MS, MCh, Ajay Iyengar, MBBS, PhD, FRACS, Nelson Alphonso, MBBS, FRACS, Julian Ayer, MBBS, PhD, FRACP |
| المصدر: | JTCVS Open, Vol 16, Iss , Pp 825-835 (2023) |
| بيانات النشر: | Elsevier, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Diseases of the circulatory (Cardiovascular) system LCC:Surgery |
| مصطلحات موضوعية: | superior cavopulmonary connection, antegrade pulmonary blood flow, Fontan, atrioventricular valve regurgitation, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811 |
| الوصف: | Objectives: Antegrade pulmonary blood flow (APBF) may be left or eliminated at the time of the superior cavopulmonary connection (SCPC). Our aim was to assess the impact of leaving native APBF at the SCPC on long-term Fontan outcomes. Methods: In the Australia and New Zealand Fontan Registry (1985-2021), 587 patients had pre-existing native APBF at the SCPC. At the SCPC, 302 patients had APBF eliminated (APBF−) and 285 patients had APBF maintained (APBF+). The incidence of Fontan failure (composite end point of Fontan takedown, transplant, plastic bronchitis, protein losing enteropathy and death) and atrioventricular (AV) valve repair/replacement post SCPC was compared between the 2 groups. Results: Sex, predominant-ventricle morphology, isomerism, primary diagnosis, and age/type of Fontan were similar between groups. APBF− versus APBF+ had a higher incidence of arch obstruction/coarctation (17% vs 7%) and previous pulmonary artery band (54% vs 45%) and a lower rate of Fontan fenestration (27% vs 41%). The risk of Fontan failure was similar between the 2 groups (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.58-1.78; P = .96). The risk of AV-valve repair/replacement was greater in APBF+ versus APBF– (HR, 2.32; CI, 1.13-4.75; P = .022). The risk of AV-valve repair/replacement remained after adjustment for arch obstruction/coarctation, previous pulmonary artery band and Fontan fenestration (HR, 2.27; CI, 1.07-4.81; P = .033). Conclusions: Maintaining APBF at the time of the SCPC does not impact the risk of Fontan failure but may increase the incidence of AV-valve repair and/or replacement post-SCPC. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2666-2736 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S2666273623002772; https://doaj.org/toc/2666-2736 |
| DOI: | 10.1016/j.xjon.2023.09.009 |
| URL الوصول: | https://doaj.org/article/c668e21ab72346208c5af65a933ef06b |
| رقم الانضمام: | edsdoj.668e21ab72346208c5af65a933ef06b |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 26662736 |
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| DOI: | 10.1016/j.xjon.2023.09.009 |