Document Detail


Interim mortality in pulmonary atresia with intact ventricular septum.
MedLine Citation:
PMID:  15561017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent work has focused attention on interim mortality (death after hospital discharge and before second-stage surgery) in hypoplastic left heart syndrome. This study investigates interim mortality in infants undergoing systemic-to-pulmonary artery shunts for pulmonary atresia with intact ventricular septum. METHODS: At two centers in 11 years (January 1991 through December 2001), 35 infants underwent placement of shunts for palliation of pulmonary atresia with intact septum. Patients were identified from the cardiology database at each institution, and data were collected retrospectively. The infants were classified into two groups, with and without severe right ventricular hypoplasia, based on the initial surgical plan (Fontan or two-ventricle repair). RESULTS: The mean age and weight of the infants were 9 days and 3.1 kg. The right ventricle was severely hypoplastic in 22 of 35 infants. Hospital death occurred in 2 patients (9.1%), 1 with severe right ventricular hypoplasia. The remaining 33 patients form the study population. There were a total of 5 deaths (15%) after discharge and before second-stage operation, all in patients with severe right ventricular hypoplasia. Two patients, 1 with hypoplastic right ventricle, died after second-stage operation. CONCLUSIONS: These data confirm a significant incidence of interim death in infants with pulmonary atresia and hypoplastic right ventricle. The interim mortality rate in the current two-institution study of infants with pulmonary atresia with intact ventricular septum is similar to that in hypoplastic left heart syndrome if all patients are considered (15%), and is somewhat higher (24%) than that for hypoplastic left heart syndrome if only patients with severe right ventricular hypoplasia are considered. This rate of interim death must be considered when different treatment options (such as shunt or transplant) are contemplated.
Authors:
Kathleen N Fenton; Frank A Pigula; Sanjiv K Gandhi; Linda Russo; Kim F Duncan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  78     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-11-24     Completed Date:  2005-07-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1994-8; discussion 1998     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, Children's Hospital, Omaha, Nebraska 68114, USA. kfenton@chsomaha.org
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / mortality
Heart Bypass, Right / mortality*
Heart Septum
Heart Ventricles / abnormalities*,  surgery
Hospital Mortality
Humans
Infant
Infant, Newborn
Palliative Care
Pulmonary Atresia / mortality*,  surgery
Retrospective Studies

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


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