Left Pulmonary Artery Sling: Postoperative Outcomes for Patients at a Single Center
Autor: | John E. Mayer, Mahwish Haider, Laura Carlson, Christopher W. Baird, Meena Nathan, Hua Liu |
---|---|
Rok vydání: | 2021 |
Předmět: |
Heart Defects
Congenital medicine.medical_specialty Pulmonary Artery Single Center Intracardiac injection Sling (weapon) law.invention law medicine Humans Esophagus Retrospective Studies business.industry Infant General Medicine Left pulmonary artery respiratory system Right pulmonary artery Intensive care unit Surgery Treatment Outcome medicine.anatomical_structure Concomitant Pediatrics Perinatology and Child Health Tracheal Stenosis Cardiology and Cardiovascular Medicine business |
Zdroj: | World Journal for Pediatric and Congenital Heart Surgery. 12:715-727 |
ISSN: | 2150-136X 2150-1351 |
Popis: | Background Left pulmonary artery (LPA) sling is a rare anomaly characterized by the origin of the LPA from the right pulmonary artery with a course between the trachea and esophagus. It is often associated with airway and cardiac anomalies. Methods This is a retrospective case series of consecutive patients who underwent LPA sling repair (LPASR) at a tertiary care center over a 35-year period with a focus on tracheal and/or LPA reinterventions and survival. Results Between June 1983 and July 2018, 42 patients were identified: isolated LPASR was performed in 16 (38%), LPASR/intracardiac repair in 10 (24%), and LPASR/tracheal repair in 16 (38%). There were 5 (12%) in-hospital and 4 (10%) late deaths. Survival rates (15 years) were as follows: 100% (isolated LPASR), 65% (concomitant intracardiac repair), and 52% (concomitant tracheal surgery). Preoperative intensive care unit (ICU) hospitalization was associated with future intervention on the LPA/trachea (61%, 11/18). The median distribution of blood flow to the left lung post-index surgery was 38%. Freedom from isolated LPA intervention was 100% after isolated LPASR, 93% after LPASR/tracheal surgery, and 69% after LPASR/intracardiac repair. Freedom from isolated tracheal intervention was 92% after isolated LPASR, 73% after LPASR/tracheal surgery, and 78% after LPASR/intracardiac repair. Conclusions ICU hospitalization prior to index surgery may indicate the severity of associated cardiac/tracheal abnormalities as this is associated with increased morbidity and mortality. Patients who underwent LPASR/intracardiac surgery were more likely to undergo isolated LPA intervention and those who underwent LPASR/tracheal surgery were more likely to undergo isolated tracheal intervention. |
Databáze: | OpenAIRE |
Externí odkaz: |