Outcomes Following Heterotopic Placement of Right Ventricle to Pulmonary Artery Conduits.

Autor:	Saxena A; Heart Centre for Children, The 8538Children's Hospital at Westmead, New South Wales, Australia., Salve GG; Heart Centre for Children, The 8538Children's Hospital at Westmead, New South Wales, Australia., Betts K; 64827School of Public Health, Curtin University, Perth, Australia., Arora N; Heart Centre for Children, The 8538Children's Hospital at Westmead, New South Wales, Australia., Cole AD; Heart Centre for Children, The 8538Children's Hospital at Westmead, New South Wales, Australia., Sholler GF; Heart Centre for Children, The 8538Children's Hospital at Westmead, New South Wales, Australia.; School of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia., Orr Y; Heart Centre for Children, The 8538Children's Hospital at Westmead, New South Wales, Australia.; School of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia., Ayer JG; Heart Centre for Children, The 8538Children's Hospital at Westmead, New South Wales, Australia.; School of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia., Winlaw DS; Heart Centre for Children, The 8538Children's Hospital at Westmead, New South Wales, Australia.; School of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	World journal for pediatric & congenital heart surgery [World J Pediatr Congenit Heart Surg] 2021 Mar; Vol. 12 (2), pp. 220-229.
DOI:	10.1177/2150135120975769
Abstrakt:	Background: We sought to evaluate the outcomes following right ventricle to pulmonary artery (RV-PA) conduit placement in pediatric patients, excluding those with a RV-PA conduit for the Ross procedure which is associated with improved conduit durability, partly related to its orthotopic position. Methods: Outcomes for 119 patients who underwent RV-PA conduit placement at a single institution from January 2004 to December 2016 were reviewed. Primary outcome measures were reintervention-free survival (RFS) and overall survival. Survival analyses were performed using the Kaplan-Meier method, and risk factors associated with reintervention were evaluated. Results: The median age at the time of conduit placement was 6 months (interquartile range, IQR: 1-14), and the median length of follow-up was 63 months (range: 0-156). During follow-up, 39 patients required conduit-related reintervention, while 6 patients died perioperatively with an overall survival of 90% at 10 years. Among the remaining 113 patients, the RFS at one, five, and ten years was 91% (84%-95%), 72% (60%-80%), and 33% (16%-50%), respectively. The median time to conduit replacement in the series was 43.5 months (IQR: 19.3-76.2). The use of a pulmonary homograft was associated with improved RFS ( P = .03), and this was particularly pronounced in comparison with aortic homografts in neonates. Infection was the indication for replacement in only one patient. Conclusions: The majority of the conduits placed during the neonatal period required conduit replacement before the age of five years. Endocarditis was not a common indication for replacement. In neonates and infants, we prefer pulmonary homografts for most indications.
Databáze:	MEDLINE
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