The effect of a valved small conduit on systemic ventricle–pulmonary artery shunt in the Norwood-type palliation
| Autor: | Satoshi Asada, Keiichi Itatani, Hitoshi Yaku, Eijiro Yamashita, Shuhei Fujita, Hisayuki Hongu, Yoshinobu Maeda, Yuji Takayanagi, Hiroki Nakatsuji, Masaaki Yamagishi |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Palliative care Heart Ventricles medicine.medical_treatment Pulmonary Artery 030204 cardiovascular system & hematology Hypoplastic left heart syndrome Bidirectional Glenn procedure 03 medical and health sciences 0302 clinical medicine Internal medicine medicine.artery Hypoplastic Left Heart Syndrome medicine Humans Retrospective Studies Ejection fraction business.industry General Medicine medicine.disease Treatment Outcome medicine.anatomical_structure 030228 respiratory system Pulmonary artery Cardiology Surgery Norwood procedure Cardiology and Cardiovascular Medicine business Shunt (electrical) Artery |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 57:1105-1112 |
| ISSN: | 1873-734X 1010-7940 |
| Popis: | OBJECTIVES The aim of this study was to clarify the impact of valved systemic ventricle–pulmonary artery (SV–PA) shunt on outcomes after stage-1 Norwood-type palliation (NP) compared with the modified Blalock–Taussig shunt. METHODS Consecutive patients who underwent NP between 2003 and 2019 were enrolled. SV–PA shunts using the expanded polytetrafluoroethylene valved conduit were implanted in 18 patients (valved SV–PA group), and another 18 patients underwent modified Blalock–Taussig shunt during NP (modified Blalock–Taussig shunt group). All valved conduits were made in our institution in advance. RESULTS No differences in baseline characteristics were found between the groups, except for shunt size. During a median 2.9 (interquartile range 0.4–6.4, maximum 14.2) years of follow-up, 8 (22.2%) patients died across both groups. There were no statistically significant differences in early mortality (5.5% vs 11.1%, P = 0.55) and overall survival rates at 5 years (80.8% vs 71.4%, P = 0.48) in the valved SV–PA and modified Blalock–Taussig shunt groups. No statistically significant difference was observed in the frequency of interventions between the groups (31% vs 33%, P = 1.0). At the time of the bidirectional Glenn procedure, the systemic ventricular end-diastolic volume index was significantly lower (84 ± 24 vs 106 ± 31 ml/m2, P = 0.05) and the ejection fraction was significantly greater (62 ± 8% vs 55 ± 9%, P = 0.03) in the valved SV–PA group. There was no statistically significant difference in the pulmonary artery index (228 ± 85 vs 226 ± 60 mm2/m2, P = 0.92). CONCLUSIONS A valved SV–PA shunt using an expanded polytetrafluoroethylene valved conduit was associated with preserved ventricular function after NP and did not impair pulmonary artery growth by controlling pulmonary regurgitation. |
| Databáze: | OpenAIRE |
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