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Outcomes and Risk Factors of Interventions for Pediatric Post-operative Pulmonary Vein Stenosis.
Fujita, Kristin T; DiLorenzo, Michael P; Krishnan, Usha S; Turner, Mariel E; Barry, Oliver M; Torres, Alejandro J; Bacha, Emile A; Kalfa, David; Crystal, Matthew A.
Afiliación
  • Fujita KT; Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA. ko2464@cumc.columbia.edu.
  • DiLorenzo MP; Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA.
  • Krishnan US; Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA.
  • Turner ME; Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA.
  • Barry OM; Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA.
  • Torres AJ; Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA.
  • Bacha EA; Division of Pediatric Cardiovascular Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA.
  • Kalfa D; Division of Pediatric Cardiovascular Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA.
  • Crystal MA; Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA.
Pediatr Cardiol ; 44(8): 1778-1787, 2023 Dec.
Article en En | MEDLINE | ID: mdl-37422845
Pulmonary vein stenosis (PVS) in children is a challenging condition with poor outcomes. Post-operative stenosis can occur after repair of anomalous pulmonary venous return (APVR) or stenosis within native veins. There is limited data on the outcomes of post-operative PVS. Our objective was to review our experience and assess surgical and transcatheter outcomes. Single-center retrospective study was performed including patients < 18 years who developed restenosis after baseline pulmonary vein surgery that required additional intervention(s) from 1/2005 to 1/2020. Non-invasive imaging, catheterization and surgical data were reviewed. We identified 46 patients with post-operative PVS with 11 (23.9%) patient deaths. Median age at index procedure was 7.2 months (range 1 month-10 years), and median follow-up was 10.8 months (range 1 day-13 years). Index procedure was surgical in 36 (78.3%) and transcatheter in 10 (21.7%). Twenty-three (50%) patients developed vein atresia. Mortality was not associated with number of affected veins, vein atresia, or procedure type. Single ventricle physiology, complex congenital heart disease (CCHD), and genetic disorders were associated with mortality. Survival rate was higher in APVR patients (p = 0.03). Patients with three or more interventions had a higher survival rate compared to patients with 1-2 interventions (p = 0.02). Male gender, necrotizing enterocolitis, and diffuse hypoplasia were associated with vein atresia. In post-operative PVS, mortality is associated with CCHD, single ventricle physiology, and genetic disorders. Vein atresia is associated with male gender, necrotizing enterocolitis, and diffuse hypoplasia. Multiple repeated interventions may offer a patient survival benefit; however, larger prospective studies are necessary to elucidate this relationship further.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Venas Pulmonares / Síndrome de Cimitarra / Enterocolitis Necrotizante / Estenosis de Vena Pulmonar / Corazón Univentricular Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans / Infant / Male / Newborn Idioma: En Revista: Pediatr Cardiol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Venas Pulmonares / Síndrome de Cimitarra / Enterocolitis Necrotizante / Estenosis de Vena Pulmonar / Corazón Univentricular Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Humans / Infant / Male / Newborn Idioma: En Revista: Pediatr Cardiol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos