Abstract:
OBJECTIVE:To examine early outcomes for pulmonary atresia with intact ventricular septum undergoing single-ventricle palliation and to determine risk factors for mortality. DESIGN:Retrospective observational study. SETTING:Tertiary paediatric critical care unit. INTERVENTION:Risk factors for mortality were sought for infants after the primary intervention whether surgical shunt or ductal stent. MEASUREMENTS AND MAIN RESULTS:We reviewed outcomes of 19 infants with pulmonary atresia with intact ventricular septum undergoing single-ventricle palliation between July, 2000 and July, 2008. Echocardiograms, cardiac catheterisation findings, anaesthesia, and critical care management, as well as autopsy reports were reviewed. We modelled survival after surgery and looked for predictors of early mortality. A total of 19 infants underwent single-ventricle palliation and seven of these died. The risk of death was increased by a lower arterial pH at induction of anaesthesia (p = 0.01), a lower systolic blood pressure (p = 0.01), and technical problems during surgery (p = 0.03). On admission to the critical care unit, a lower mixed venous saturation (p = 0.02) and presence of tachyarrhythmia (p = 0.02) were associated with the need for mechanical support within the first 48 hours. CONCLUSIONS:There is a high early mortality for those who undergo single-ventricle palliation. It is higher for those who are haemodynamically compromised before surgery; technical problems, and haemodynamic instability during surgery also increase mortality.
journal_name
Cardiol Youngjournal_title
Cardiology in the youngauthors
Walsh MA,Asoh K,Van Arsdell GS,Humpl Tdoi
10.1017/S1047951110000077subject
Has Abstractpub_date
2010-06-01 00:00:00pages
290-6issue
3eissn
1047-9511issn
1467-1107pii
S1047951110000077journal_volume
20pub_type
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journal_title:Cardiology in the young
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journal_title:Cardiology in the young
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journal_title:Cardiology in the young
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doi:10.1017/S1047951114001127
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pub_type: 杂志文章,评审
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