التفاصيل البيبلوغرافية
| العنوان: |
Intact Right Ventricle-Pulmonary Artery Shunt After Stage 2 Palliation in Hypoplastic Left Heart Syndrome Improves Pulmonary Artery Growth. |
| المؤلفون: |
Turner, Mariel, Richmond, Marc, Quaegebeur, Jan, Shah, Amee, Chen, Jonathan, Bacha, Emile, Vincent, Julie |
| المصدر: |
Pediatric Cardiology; Apr2013, Vol. 34 Issue 4, p924-930, 7p, 1 Diagram, 4 Charts, 1 Graph |
| مصطلحات موضوعية: |
HEART diseases, PULMONARY artery, PALLIATIVE treatment, RIGHT heart ventricle, SURGICAL anastomosis |
| مستخلص: |
For patients with hypoplastic left heart syndrome who have undergone the Norwood procedure with a right ventricle-pulmonary artery (RV-PA) shunt, the shunt can either be removed or left intact at the time of the stage 2 procedure. This study aimed to determine the effects of an intact shunt on pulmonary artery growth and clinical outcomes after the stage 2 procedure. A retrospective review of patients who underwent Norwood with an RV-PA shunt from 2005 to 2010 was performed. Catheterization data, echocardiographic data, postoperative outcome variables, and mortality data were collected. Pulmonary artery size was measured at pre-stage 2 and pre-Fontan catheterizations using the Nakata Index and the McGoon Ratio. Of the 68 patients included in the study, 48 had the shunt removed at the time of stage 2 (group 1), and 20 had the shunt left intact (group 2). The two groups did not differ in terms of pre-stage 2 hemodynamics or pulmonary artery size. After stage 2, group 2 had higher oxygen saturations. The two groups did not differ regarding duration of chest tube drainage, length of hospital stay, need for unplanned interventions, or mortality. Before Fontan, the group 2 patients had higher superior vena cava (SVC) pressures and more venovenous collaterals closed. There was increased pulmonary artery growth between the pre-stage 2 and pre-Fontan catheterizations in group 2 using both the Nakata Index (+148.5 vs −52.4 mm/m; p = 0.01) and the McGoon Ratio (+0.36 vs +0.01; p = 0.01). These findings indicate that patients with an intact RV-PA shunt after stage 2 have greater pulmonary artery growth than patients with the shunt removed, with no increased risk of complications. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
