Background: Second-stage palliation with hemi-Fontan or bidirectional Glenn procedures has improved the outcomes of patients treated for single-ventricle heart disease. The aim of this study was to retrospectively analyze risk factors for death after second-stage palliation of single-ventricle heart and to compare therapeutic results achieved with the hemi-Fontan and bidirectional Glenn procedures.
Material And Methods: We analyzed 60 patients who had undergone second-stage palliation for single-ventricle heart. Group HF consisted of 23 (38.3%) children who had been operated with the hemi-Fontan method; Group BDG consisted of 37 (61.7%) who had been operated with the bidirectional Glenn method. The analysis focused on 30-day postoperative mortality rates, clinical and echocardiographic data, and early complications.
Results: The patients' ages at the time of repair was 33 ± 11.2 weeks; weight was 6.7 ± 1.2 kg. The most common anatomic subtype was hypoplastic left heart syndrome, in 36 (60%) patients. The early mortality rate was 13.3%. Significant preoperative atrioventricular valve regurgitation, single-ventricle heart dysfunction, pneumonia/sepsis, and arrhythmias were associated with higher mortality rates after second-stage palliation. Multivariate analysis identified significant preoperative single-ventricle heart dysfunction as an independent predictor of early death after second-stage palliation. No differences were found in the analyzed variables after bidirectional Glenn compared with hemi-Fontan procedures.
Conclusion: Significant preoperative atrioventricular valve regurgitation, arrhythmias and pneumonia/sepsis are closely correlated with mortality in patients with single-ventricle heart after second-stage palliation. Preoperative significant single-ventricle heart dysfunction is an independent mortality predictor in this group of patients. There are no differences in clinical, echocardiographic data, or outcomes in patients treated with the hemi-Fontan compared with bidirectional Glenn procedures.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594433 | PMC |
| http://dx.doi.org/10.1186/s12947-017-0114-7 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of echocardiographic and computed-tomography assessment of Sano shunt stenosis on need for percutaneous intervention.
Int J Cardiovasc Imaging
February 2025
The Heart Institute, Children's Hospital Colorado, School of Medicine, University of Colorado Denver| Anschutz Medical Campus, 13123 East 16th Avenue, Box 100, Aurora, CO, 80045-2560, USA.
The decision for Sano re-intervention is made on the patient's clinical condition and imaging suggestive of conduit stenosis; however, no consensus exists on what imaging parameters best identify patients requiring re-intervention. We undertook a single center retrospective cohort study of patients who underwent a Norwood-Sano procedure to understand which echocardiographic and CT parameters were associated with intervention prior to second-stage palliation. Proximal and distal Sano Doppler velocity and peak gradients (PG) were recorded from TTE performed prior to Sano stenting or second-stage palliation if no intervention performed.
View Article and Find Full Text PDFInterstage feeding and caregiver impact on single ventricle patients.
Cardiol Young
February 2025
Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, USA.
Background: The interstage period is a critical phase for single ventricle infants due to their fragile cardiovascular state. Infants often experience medical and feeding challenges during this period, resulting in caregiver stress. We completed a quality improvement project at Children's Healthcare of Atlanta to understand these challenges to inform targeted interventions.
View Article and Find Full Text PDFPrimary vs Staged Biventricular Repair for Neonatal IAA with VSD and LVOTO.
Ann Thorac Surg Short Rep
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, Duke University Hospital, Durham, North Carolina.
Background: This study sought to determine the safety of primary and staged biventricular repair in neonates with interrupted aortic arch (IAA), ventricular septal defect (VSD), and severe left ventricular outflow tract obstruction (LVOTO).
Methods: Patients with a fundamental diagnosis of IAA and VSD between 2015 and 2020 were extracted from The Society of Thoracic Surgeons National Database by using a Participant User File. The objective was to compare outcomes for neonates undergoing primary and staged Yasui and Ross operations.
Rescuing the Right Ventricle: Mechanical Support After Pediatric Heart Transplantation.
Ann Thorac Surg Short Rep
June 2024
Department of Cardiothoracic Surgery and Perfusion Services, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio.
Background: Right ventricular (RV) failure after heart transplantation (HT) is common in those with pretransplantation elevated pulmonary vascular resistance (PVR). Mechanical circulatory support has been used as a bridge to recovery, with mixed outcomes. We describe a patient with failed single-ventricle palliation in whom severe RV failure developed after HT.
View Article and Find Full Text PDFHeartMate 3 Ventricular Assist Device in a Single-Ventricle and Single-Lung Patient Palliated With a Bidirectional Glenn.
ASAIO J
October 2024
From the Pediatric Cardiac Surgery Unit, Cardiovascular Surgery Division, Instituto do Coração (Heart Institute), Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
We describe a 15 year old patient with failing second-stage single-ventricle palliation and left pulmonary artery thrombosis successfully supported with HeartMate 3 ventricular assist device and a Fontan completion as destination therapy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!