Echocardiographic Identification of Pulmonary Artery Flow Reversal: An Indicator of Adverse Outcomes in Single Ventricle Physiology

Autor:	Andrew D, Spearman, Salil, Ginde, Benjamin H, Goot, Amy M, Schaal, Mingen, Feng, Amy Y, Pan, Michele A, Frommelt, Peter C, Frommelt
Rok vydání:	2020
Předmět:	Heart Defects Congenital Male Pulmonary Circulation Heart Ventricles Infant Length of Stay Pulmonary Artery Fontan Procedure Survival Rate Postoperative Complications Treatment Outcome Wisconsin Echocardiography Child Preschool Humans Female Child Retrospective Studies
Zdroj:	Pediatric cardiology. 41(8)
ISSN:	1432-1971
Popis:	Individuals with single ventricle congenital heart disease (CHD) undergo multiple staged surgical palliations. Staged single ventricle palliation with a superior cavopulmonary connection (SCPC) in infancy followed by a Fontan in early childhood relies on passive, unobstructed pulmonary blood flow and normal pulmonary vasculature. We hypothesized that patients with echocardiographic identification of retrograde flow in a branch pulmonary artery (PA) after SCPC or Fontan are at increased risk for adverse outcomes. We conducted a retrospective chart review of patients seen at Children's Wisconsin from 1999 to 2019. Inclusion criteria included a history of single ventricle congenital heart disease and surgical palliation with a superior cavopulmonary connection (SCPC). We created two cohorts based on transthoracic echocardiographic identification of branch PA flow patterns: those with color Doppler-defined pulmonary artery flow reversal (PA reversal cohort) and those with normal anterograde flow (Non-reversal cohort). We identified 21 patients in the PA reversal cohort and 539 patients in the Non-reversal cohort. The PA reversal cohort had increased hospital length of stay after SCPC palliation (p 0.001) and decreased transplant-free survival (p = 0.032), but there was no difference in overall survival (p = 0.099). There was no difference in hospital length of stay after Fontan (p = 0.17); however, the PA reversal cohort was significantly less likely to progress to Fontan palliation during early childhood (p = 0.005). Echocardiographic color Doppler identification of branch PA flow reversal in patients with single ventricle physiology is a high-risk indicator for adverse short- and long-term outcomes.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::bcdfdf83761fcd65ba6047e8a5cc679a https://pubmed.ncbi.nlm.nih.gov/32710282 Zobrazit plný text záznamu Full text from SpringerLink