| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2005;79:29-36
© 2005 The Society of Thoracic Surgeons
a Clinic for Cardiovascular Surgery, University Hospital, Bern, Switzerland
b Clinic for Pediatric Cardiac Surgery, Centre Chirurgical Marie-Lannelongue, University Paris Sud, Le Plessis-Robinson, France
Accepted for publication June 2, 2004.
* Address reprint requests to Dr Berdat, Clinic for Cardiovascular Surgery, Swiss Cardiovascular Center Bern, Inselspital, CH-3010 Bern, Switzerland (E-mail: pascal.berdat{at}insel.ch).
BACKGROUND: Controversy continues over whether additional sources of pulmonary blood flow are beneficial in combination with a bidirectional cavopulmonary anastomosis. We have therefore assessed the effects of additional pulmonary blood flow on outcome after bidirectional cavopulmonary anastomosis.
METHODS: From 1996 to 2000, 106 patients underwent bidirectional cavopulmonary anastomosis, either isolated (group 1, n = 54), or with additional pulmonary blood flow through the pulmonary artery (group 2, n = 30) or a Blalock-Taussig shunt (group 3, n = 22).
RESULTS: Superior vena cava syndrome was more frequent in group 2 and less in groups 1 and 3 (p < 0.05). Low-output syndrome was more frequent in group 2 and less in group 3 (p = 0.01). Repeated-measures analysis of variance showed higher oxygen saturations with additional pulmonary blood flow (p < 0.05) and significant changes over time (p < 0.0001). Pulmonary pressures, systemic ventricular fractional shortening, end-diastolic diameter index, end-diastolic pressure, and atrioventricular valve regurgitation remained unaffected by additional pulmonary blood flow. Pulmonary artery pressures were lower in group 2 than 3 (p < 0.05). Fractional shortening (p < 0.05) and atrioventricular valve regurgitation (p < 0.0001) changed significantly over time. Fractional shortening showed a strong trend toward different changing patterns with or without additional pulmonary blood flow (p = 0.055), and atrioventricular valve regurgitation showed different changing patterns among the groups (p < 0.005). End-diastolic diameter and pulmonary artery dimensions, which were smaller than normal, remained unchanged. In logistic regression, smaller body surface area at bidirectional cavopulmonary anastomosis, single ventricle, and bidirectional cavopulmonary anastomosis with a Blalock-Taussig shunt were associated with early death. Actuarial survival including total cavopulmonary connection did not differ among groups (p = 0.96).
CONCLUSIONS: We conclude that additional pulmonary blood flow has no adverse effect on outcome after cavopulmonary anastomosis. Additional flow through the main pulmonary artery offers different advantages and disadvantages concerning perioperative complications and pulmonary artery growth compared with additional flow through a Blalock-Taussig shunt.
Related Article
Ann. Thorac. Surg. 2005 79: 36-37.
This article has been cited by other articles:
|
|
 |
|
  D. S. Nath, A. J. Carden, D. P. Nussbaum, A. J. Shin, R. G. Khemani, V. A. Starnes, and W. J. Wells Can the Kawashima procedure be performed in younger patients? Ann. Thorac. Surg., August 1, 2009; 88(2): 581 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. F. Calvaruso, A. Rubino, S. Ocello, N. Salviato, D. Guardi, D. F. Petruccelli, A. Cipriani, K. Fattouch, S. Agati, C. Mignosa, et al. Bidirectional Glenn and Antegrade Pulmonary Blood Flow: Temporary or Definitive Palliation? Ann. Thorac. Surg., April 1, 2008; 85(4): 1389 - 1396. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Gray, K. Altmann, R. S. Mosca, A. Prakash, I. A. Williams, J. M. Quaegebeur, and J. M. Chen Persistent Antegrade Pulmonary Blood Flow Post-Glenn Does Not Alter Early Post-Fontan Outcomes in Single-Ventricle Patients Ann. Thorac. Surg., September 1, 2007; 84(3): 888 - 893. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Schreiber, J. Horer, M. Vogt, J. Cleuziou, Z. Prodan, and R. Lange Nonfenestrated Extracardiac Total Cavopulmonary Connection in 132 Consecutive Patients Ann. Thorac. Surg., September 1, 2007; 84(3): 894 - 899. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Sarajuuri, E. Jokinen, R. Puosi, M. Eronen, L. Mildh, I. Mattila, L. Valanne, and T. Lonnqvist Neurodevelopmental and neuroradiologic outcomes in patients with univentricular heart aged 5 to 7 years: Related risk factor analysis J. Thorac. Cardiovasc. Surg., June 1, 2007; 133(6): 1524 - 1532. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Desai, J. Wright, R. Dhillon, and O. Stumper Transcatheter closure of ventriculopulmonary artery communications in staged Fontan procedures Heart, April 1, 2007; 93(4): 510 - 513. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Baslaim Effect of patent ductus arteriosus stenting on subsequent bidirectional Glenn anastomosis: A word of caution J. Thorac. Cardiovasc. Surg., April 1, 2006; 131(4): e3 - e4. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Kawahira, K. Nishigaki, T. Ueno, and N. Sekiya Bidirectional Glenn shunt with concomitant placement of extra-cardiac graft - preparatory procedure for the future total cavo-pulmonary connection Interactive CardioVascular and Thoracic Surgery, December 1, 2005; 4(6): 499 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Yoshida, M. Yamaguchi, N. Yoshimura, H. Murakami, H. Matsuhisa, and Y. Okita Appropriate Additional Pulmonary Blood Flow at the Bidirectional Glenn Procedure is Useful for Completion of Total Cavopulmonary Connection Ann. Thorac. Surg., September 1, 2005; 80(3): 976 - 981. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
