Outcome of Biventricular Repair in Infants With Multiple Left Heart Obstructive Lesions
| Autor: | René Prêtre, Emanuela R. Valsangiacomo Buechel, Angela Oxenius, Urs Bauersfeld, Anna Cavigelli-Brunner, Oliver Kretschmar |
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| Přispěvatelé: | University of Zurich, Valsangiacomo Büchel, Emanuela R |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Heart Ventricles 610 Medicine & health 2705 Cardiology and Cardiovascular Medicine Internal medicine Hypoplastic Left Heart Syndrome Medicine Humans Cardiac skeleton 10220 Clinic for Surgery 2735 Pediatrics Perinatology and Child Health Cardiac Surgical Procedures Retrospective Studies business.industry Mortality rate Infant Newborn Infant Vascular surgery medicine.disease Pulmonary hypertension Surgery Cardiac surgery 10020 Clinic for Cardiac Surgery Survival Rate medicine.anatomical_structure Treatment Outcome Ventricle 10036 Medical Clinic Echocardiography Redo surgery Pediatrics Perinatology and Child Health Failure to thrive Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Switzerland Follow-Up Studies |
| Popis: | The decision to perform biventricular repair for infants with multiple obstructive or hypoplastic left heart lesions (LHL) and borderline left ventricle (LV) may be controversial. This study sought to assess the mortality and morbidity of patients with LHL after biventricular repair and to determine the growth of the left-sided cardiac structures. Retrospective analysis of 39 consecutive infants with LHL who underwent biventricular repair was performed. The median age at surgery was 7 days (range 1–225 days), and the median follow-up period was 34 months (range 1–177 months). Between diagnosis and the end of the follow-up period, the size of the aortic annulus (z-score −4.1 ± 2.8 vs. −0.1 ± 2.7) and the LV (LV end-diastolic diameter z-score −1.7 ± 2.8 vs. 0.21 ± 1.7) normalized. During the follow-up period, 23 patients required 39 reinterventions (62%) consisting of redo surgery for 21 patients (57%) and catheter-guided reinterventions for 8 patients (22%). At the end of the follow-up period, 25 of 34 patients were doing subjectively well; 10 children (29%) received cardiac medication; 12 (35%) presented with failure to thrive (weight ≤ P3) and 5 (15%) with pulmonary hypertension. The overall mortality rate was 13%. Biventricular repair for patients with multiple LHL results in sufficient growth of the left-sided cardiac structures. Nevertheless, residual or newly developing obstructive lesions and pulmonary hypertension are frequent, causing significant morbidity that requires reintervention. |
| Databáze: | OpenAIRE |
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