Document Detail


Echocardiographic parameters that predict outcome in aortic atresia patients undergoing comprehensive stage II procedure.
MedLine Citation:
PMID:  21087424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The hybrid procedure is one option for palliating patients with hypoplastic left heart syndrome. As experience increases with this palliation, the physiology and its influence on outcome can be better assessed. The goal of this study was to determine if echocardiographic parameters correlate with post-operative variables in patients with aortic atresia undergoing the comprehensive Stage II procedure.
METHODS: Retrospective chart review on all patients with aortic atresia, who underwent the comprehensive Stage II procedure from January 2002 to December 2008, was performed. Echocardiographic indices were evaluated and correlations were made with peri-operative and hospital variables. Pair-wise Pearson's correlation tests were used to analyze the associations between continuous measures.
RESULTS: Thirty-four patients met inclusion criteria. Age at comprehensive Stage II procedure was 0.45 ± 0.13 years and body surface area was 0.31 ± 0.04 m(2). Right ventricle (RV) percentage change was 45 ± 10%, eccentricity index was 1.96 ± 0.45, estimated systemic cardiac output was 7.68 ± 2.56 L/min/m(2) and estimated effective systemic cardiac output was 5.15 ± 2.24 L/min/m(2). Retrograde patent ductus arteriosu (PDA) velocity time integral (VTI) correlated with log pre-bypass lactate and maximum lactate (r = 0.53, 0.44). PDA regurgitant fraction correlated with log post-bypass lactate, length of intubation, and urine output on day four (r = 0.39, 0.46, -0.37). RV percentage change correlated with log pre-bypass lactate, and urine output on days four and five (r =-0.38, 0.43, 0.54). No echocardiographic parameter predicted renal or liver insufficiency, dialysis, extracorporeal membrane oxygenation use, or hospital death.
CONCLUSION: Retrograde PDA VTI and RV percent change correlated with some peri-operative variables though no echocardiographic parameter was associated with any major morbidities or mortality. Newer echocardiographic techniques may better predict comprehensive stage II outcomes.
Authors:
Brian Birnbaum; Glen Berger; Bernadette Fenstermaker; Daniel G Rowland; Bethany Boettner; Vince Olshove; Mark Galantowicz; John P Cheatham; Clifford L Cua
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  5     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-11-22     Completed Date:  2011-03-04     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  409-15     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Heart Center Nationwide Childrens Hospital, Columbus, Ohio, USA.
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MeSH Terms
Descriptor/Qualifier:
Body Surface Area
Cardiac Output
Cardiac Surgical Procedures* / adverse effects,  mortality
Ductus Arteriosus, Patent / surgery,  ultrasonography
Echocardiography, Doppler, Color*
Echocardiography, Doppler, Pulsed*
Extracorporeal Membrane Oxygenation
Hospital Mortality
Humans
Hypoplastic Left Heart Syndrome / mortality,  physiopathology,  surgery*,  ultrasonography*
Infant
Liver Diseases / etiology
Ohio
Palliative Care
Predictive Value of Tests
Renal Dialysis
Renal Insufficiency / etiology,  therapy
Retrospective Studies
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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