| Pulmonary atresia with ventricular septal defects and major aortopulmonary collateral arteries. | |
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MedLine Citation:
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PMID: 19179776 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There is no consensus on the long-term outcome after unifocalization in patients undergoing surgery for pulmonary atresia with ventricular septal defects (VSD) and major aortopulmonary collateral arteries (MAPCAs). METHODS AND RESULTS: From 1988 to 2006, 40 patients (median age 8.5 months) underwent surgery for pulmonary atresia, VSD, and MAPCAs. The hospital mortality rate for the preparatory procedures was 1.2%; 17 patients had a complete repair (CR) at a median age of 3 years. Patients with a pulmonary artery index greater than 100 mm(2)/m(2) had a higher likelihood of CR. The overall survival rate 15 years after first operation in the CR group was 87.5%. Cox analysis demonstrated that increased number of MAPCAs (P=0.019, HR=1.666) was a significant predictor of poor survival, and CR (P=0.025, HR=0.141) was a significant predictor of favorable prognosis. On angiography, serial measurements of MAPCAs showed a significant decrease in size (from 5.2+/-2.9 to 4.1+/-2.9 mm after a mean of 20 months) (P<0.0001). CONCLUSIONS: Long-term survival into adulthood can be achieved with an integrated approach. Late survival depends on the number of MAPCAs, and CR. Growth potential of unifocalized MAPCAs was not definite. |
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Authors:
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Suk-Won Song; Han Ki Park; Young-Hwan Park; Bum Koo Cho |
Publication Detail:
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Type: Journal Article Date: 2009-01-28 |
Journal Detail:
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Title: Circulation journal : official journal of the Japanese Circulation Society Volume: 73 ISSN: 1346-9843 ISO Abbreviation: Circ. J. Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-02-27 Completed Date: 2009-06-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: Japan |
Other Details:
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Languages: eng Pagination: 516-22 Citation Subset: IM |
Affiliation:
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Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Aorta, Thoracic / abnormalities*, radiography, surgery Child Child, Preschool Collateral Circulation Coronary Angiography Coronary Circulation Female Follow-Up Studies Heart Septal Defects, Ventricular / mortality*, radiography, surgery* Humans Infant Infant, Newborn Kaplan-Meiers Estimate Male Pulmonary Artery / abnormalities*, radiography, surgery Pulmonary Atresia / mortality*, radiography, surgery* Reoperation / statistics & numerical data Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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