Document Detail


Mitral stenosis and aortic atresia in hypoplastic left heart syndrome: survival analysis after stage I palliation.
MedLine Citation:
PMID:  20971272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mitral stenosis with aortic atresia (MS-AA) has been implicated as a risk factor for decreased survival after stage 1 palliation for hypoplastic left heart syndrome. Conflicting results were reported in the literature evaluating the association of anatomic subtypes and mortality. Our objective was to determine whether MS-AA is associated with increased mortality after stage 1 palliation. METHODS: Between January 2005 and May 2009 100 consecutive neonates with hypoplastic left heart syndrome underwent stage 1 palliation. Echocardiograms were reviewed for patency of the mitral and aortic valves as well as presence of ventriculocoronary connections (VCC). Patients were divided into (1) mitral and aortic atresia (MA-AA), (2) MS-AA, and (3) mitral and aortic stenosis groups. Survival analysis was performed, and impact of MS-AA and VCC on early and midterm survival was assessed. RESULTS: Of the 100 patients, 31 had MA-AA, 42 had mitral stenosis and aortic stenosis, and 27 had MS-AA (15 with VCC and 12 without). Stage 1 palliation 30-day survival was 90% for the entire cohort and 88.9% for the MS-AA subtype (not significantly different). Six-month survival was 70% overall and 70.4% for MS-AA (not significantly different). When VCC was taken into account, MS-AA with VCC reached 93% survival (versus 50% for MS-AA without VCC; p < 0.01). CONCLUSIONS: Stage 1 palliation for hypoplastic left heart syndrome is associated with satisfactory hospital and midterm survival regardless of anatomic subtype. The variants MS-AA and MA-AA are associated with smaller ascending aorta. Mitral stenosis with aortic atresia or VCC did not adversely influence survival.
Authors:
Shyam K Sathanandam; Anastasios C Polimenakos; David A Roberson; Chawki F elZein; Andrew Van Bergen; Tarek S Husayni; Michel N Ilbawi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-25     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1599-607; discussion 1607-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Pediatric Cardiovascular Surgery, The Heart Institute for Children at Advocate Hope Children's Hospital, Oak Lawn, Illinois, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aortic Valve / abnormalities*
Cardiac Surgical Procedures
Female
Hospital Mortality
Humans
Hypoplastic Left Heart Syndrome / mortality,  surgery*
Infant, Newborn
Male
Mitral Valve Stenosis / mortality*
Palliative Care

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


Previous Document:  Invited commentary.
Next Document:  Medium-term outcomes of kawashima and completion fontan palliation in single-ventricle heart disease...