Left Pulmonary Artery Sling: Postoperative Outcomes for Patients at a Single Center.
World J Pediatr Congenit Heart Surg
; 12(6): 715-727, 2021 11.
Article
en En
| MEDLINE
| ID: mdl-34846972
BACKGROUND: Left pulmonary artery (LPA) sling is a rare anomaly characterized by the origin of the LPA from the right pulmonary artery with a course between the trachea and esophagus. It is often associated with airway and cardiac anomalies. METHODS: This is a retrospective case series of consecutive patients who underwent LPA sling repair (LPASR) at a tertiary care center over a 35-year period with a focus on tracheal and/or LPA reinterventions and survival. RESULTS: Between June 1983 and July 2018, 42 patients were identified: isolated LPASR was performed in 16 (38%), LPASR/intracardiac repair in 10 (24%), and LPASR/tracheal repair in 16 (38%). There were 5 (12%) in-hospital and 4 (10%) late deaths. Survival rates (15 years) were as follows: 100% (isolated LPASR), 65% (concomitant intracardiac repair), and 52% (concomitant tracheal surgery). Preoperative intensive care unit (ICU) hospitalization was associated with future intervention on the LPA/trachea (61%, 11/18). The median distribution of blood flow to the left lung post-index surgery was 38%. Freedom from isolated LPA intervention was 100% after isolated LPASR, 93% after LPASR/tracheal surgery, and 69% after LPASR/intracardiac repair. Freedom from isolated tracheal intervention was 92% after isolated LPASR, 73% after LPASR/tracheal surgery, and 78% after LPASR/intracardiac repair. CONCLUSIONS: ICU hospitalization prior to index surgery may indicate the severity of associated cardiac/tracheal abnormalities as this is associated with increased morbidity and mortality. Patients who underwent LPASR/intracardiac surgery were more likely to undergo isolated LPA intervention and those who underwent LPASR/tracheal surgery were more likely to undergo isolated tracheal intervention.
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Texto completo:
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Estenosis Traqueal
/
Cardiopatías Congénitas
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
/
Infant
Idioma:
En
Revista:
World J Pediatr Congenit Heart Surg
Año:
2021
Tipo del documento:
Article
Pais de publicación:
Estados Unidos