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Impact of Atrioventricular Valve Intervention at Each Stage of Single Ventricle Palliation.
Vossler, John D; Eckhauser, Aaron W; Griffiths, Eric R; Hobbs, Reilly D; Lambert, Linda M; Tani, Lloyd Y; Parsons, Niharika; Habib, Robert H; Jacobs, Jeffrey P; Jacobs, Marshall L; Husain, S Adil.
Afiliación
  • Vossler JD; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of California, San Diego, CA, USA.
  • Eckhauser AW; Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
  • Griffiths ER; Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
  • Hobbs RD; Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
  • Lambert LM; Primary Children's Hospital, Heart Center, Salt Lake City, UT, USA.
  • Tani LY; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
  • Parsons N; Research and Analytic Center, The Society of Thoracic Surgeons, Chicago, IL, USA.
  • Habib RH; Research and Analytic Center, The Society of Thoracic Surgeons, Chicago, IL, USA.
  • Jacobs JP; Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, FL, USA.
  • Jacobs ML; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
  • Husain SA; Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
World J Pediatr Congenit Heart Surg ; : 21501351241269924, 2024 Sep 05.
Article en En | MEDLINE | ID: mdl-39238284
ABSTRACT

Background:

Significant atrioventricular valve dysfunction can be associated with mortality or need for transplant in functionally univentricular heart patients undergoing staged palliation. The purposes of this study are to characterize the impact of concomitant atrioventricular valve intervention on outcomes at each stage of single ventricle palliation and to identify risk factors associated with poor outcomes in these patients.

Methods:

The Society of Thoracic Surgeons Congenital Heart Surgery Database was queried for functionally univentricular heart patients undergoing single ventricle palliation from 2013 through 2022. Separate analyses were performed on cohorts corresponding to each stage of palliation (1 initial palliation; 2 superior cavopulmonary anastomosis; 3 Fontan procedure). Bivariate analysis of demographics, diagnoses, comorbidities, preoperative risk factors, operative characteristics, and outcomes with and without concomitant atrioventricular valve intervention was performed. Multiple logistic regression was used to identify predictors associated with operative mortality or major morbidity.

Results:

Concomitant atrioventricular valve intervention was associated with an increased risk of operative mortality or major morbidity for each cohort (cohort 1 62% vs 46%, P < .001; cohort 2 37% vs 19%, P < .001; cohort 3 22% vs 14%, P < .001). Black race in cohort 1 (odds ratio [OR] 3.151, 95% CI 1.181-9.649, P = .03) and preterm birth in cohort 2 (OR 1.776, 95% CI 1.049-3.005, P = .032) were notable predictors of worse morbidity or mortality.

Conclusions:

Concomitant atrioventricular valve intervention is a risk factor for operative mortality or major morbidity at each stage of single ventricle palliation. Several risk factors are associated with these outcomes and may be useful in guiding decision-making.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World J Pediatr Congenit Heart Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World J Pediatr Congenit Heart Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos