AI Article Synopsis
- A study assessed the prevalence of veno-venous collaterals (VVCs) in patients who underwent total cavopulmonary connection (TCPC) from 1994 to 2022, finding VVCs in 15% of those evaluated.
- The research included 635 patients, most commonly diagnosed with hypoplastic left heart syndrome, with VVCs developing around 2.8 years post-surgery.
- While VVCs did not significantly affect survival rates, they were linked to an increased risk for plastic bronchitis, and interventional closure of VVCs improved oxygen saturation in 66% of treated patients.
Article Abstract
Objective: To evaluate the prevalence of veno-venous collaterals (VVCs) after total cavopulmonary connection (TCPC) and analyze their impact on outcomes.
Methods: Patients undergoing TCPC between 1994 and 2022 were evaluated. VVCs were identified using angiograms of cardiac catheterizations and their impact on outcomes was analyzed.
Results: A total of 635 patients were included. Median age at TCPC was 2.3 (interquartile ranges (IQR): 1.8-3.3) years. The most frequent diagnosis was hypoplastic left heart syndrome in 173 (27.2%) patients. Prior bidirectional cavopulmonary shunt was performed in 586 (92.3%) patients at a median age of 5.3 (3.6-9.9) months. VVCs were found in 94 (14.8%) patients at a median of 2.8 (0.1-11.8) years postoperatively. The prevalence of VVCs was similar between the dominant right and left ventricle (14.7 vs. 14.9%, p = 0.967). Mean pulmonary artery pressure (16.2 vs. 16.0 mmHg, p = 0.902), left atrial pressure (5.5 vs. 5.7 mmHg, p = 0.480), transpulmonary gradient (4.0 vs. 3.8 mmHg, p = 0.554) and oxygen saturation (81.4 vs. 82.6%, p = 0.103) before TCPC were similar between patients with and without VVCs. The development of VVCs did not affect survival after TCPC (p = 0.161). Nevertheless, VVCs were a risk for the development of plastic bronchitis (PB, p < 0.001). Interventional closure of VVCs was performed in 60 (9.4%) patients at a median of 8.9 (0.6-15.1) years after TCPC, and improvement of oxygen saturation was observed in 66% of the patients.
Conclusions: The prevalence of VVCs after TCPC was 15%. VVCs had no impact on survival following TCPC but were associated with a high prevalence of PB.
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| http://dx.doi.org/10.1016/j.ijcard.2024.132229 | DOI Listing |
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Article Synopsis
- A study assessed the prevalence of veno-venous collaterals (VVCs) in patients who underwent total cavopulmonary connection (TCPC) from 1994 to 2022, finding VVCs in 15% of those evaluated.
- The research included 635 patients, most commonly diagnosed with hypoplastic left heart syndrome, with VVCs developing around 2.8 years post-surgery.
- While VVCs did not significantly affect survival rates, they were linked to an increased risk for plastic bronchitis, and interventional closure of VVCs improved oxygen saturation in 66% of treated patients.
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