Abstract:
OBJECTIVES:The effect of antegrade pulmonary blood flow (APBF) has never been studied in the bidirectional Glenn (BDG) procedure performed late. METHODS:Records of 112 consecutive patients who had a BDG procedure during a 10-year period were reviewed retrospectively. The patients were divided into 2 groups based on whether APBF occurred following the BDG procedure (APBF group, n = 81) or not (non-APBF group, n = 31). The median age at the BDG procedure was 6.16 ± 3.93 years in the APBF group and 6.12 ± 4.40 years in the non-APBF group. RESULTS:Demographics and pre- and intraoperative variables were comparable for both groups. Follow-up data were obtained for patients at the BDG stage and for those who had undergone the Fontan completion. Both oxygen saturation levels (81.72 ± 1.976% vs 78.32 ± 2.344%, P < 0.01) and pulmonary pressure (13.59 ± 1.376 mmHg vs 12.90 ± 0.978 mmHg, P = 0.012) were higher in the APBF group immediately after the BDG procedure. Both the duration of chest tube drainage and the total length of stay were longer in the APBF group. The pre-Glenn measurements showed a mean McGoon ratio of 1.68 ± 0.114 in the APBF group and 1.67 ± 0.098 in the non-APBF group (P = 0.474). The McGoon ratios measured before the Fontan procedure were also comparable (1.669 ± 0.726 vs 1.685 ± 0.669, P = 0.576). At the pre-Fontan measurement, there was no significant difference in mean pulmonary artery pressures between the groups (13.72 ± 1.368 vs 13.50 ± 1.265, P = 0.653). Fifty-nine patients underwent the Fontan completion (43 from the APBF group and 16 from the non-APBF group) procedure with a median of 1.2 (APBF group) and 1.4 (non-APBF group) years after the BDG procedure. No significant differences between groups were observed in arterial oxygen saturation levels, incidence of systemic atrioventricular valve regurgitation or ventricular dysfunction in survivors at the last follow-up visit. CONCLUSIONS:The BDG procedure can be safely performed at a relatively older age (∼6 years). APBF increases oxygen saturation but also prolongs pleural effusion and hospital stay. Medium-term outcomes and the Fontan completion rate in the APBF and the non-APBF groups are comparable. Further large studies and long-term follow-up are needed to clarify the effect of APBF in patients who have the late BDG.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Yan T,Tong G,Zhang B,Yan F,Zhou X,Wang X,Lu H,Ma T,Wang X,Yu H,Sun Z,Zhang Wdoi
10.1093/icvts/ivx325subject
Has Abstractpub_date
2018-03-01 00:00:00pages
454-459issue
3eissn
1569-9293issn
1569-9285pii
4540716journal_volume
26pub_type
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
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journal_title:Interactive cardiovascular and thoracic surgery
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doi:10.1510/icvts.2007.156554
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
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更新日期:2010-02-01 00:00:00
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更新日期:2010-12-01 00:00:00
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更新日期:2017-01-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
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更新日期:2013-07-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
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更新日期:2007-12-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
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更新日期:2004-03-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
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更新日期:2018-09-01 00:00:00