دورية أكاديمية
Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?
| العنوان: | Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved? |
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| المؤلفون: | Manuel V; 1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.; 2 Division of Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Morais H; 3 Cardiology Department, Hospital Militar Principal/Instituto Superior, Luanda, Angola., Turquetto ALR; 2 Division of Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Miguel G; 1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola., Miana LA; 2 Division of Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Pedro A; 1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.; 4 Pediatric Cardiology Department, Cardiac Surgery Department, Portuguese Red Cross Hospital, Lisbon, Portugal., Nunes MAS; 1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.; 4 Pediatric Cardiology Department, Cardiac Surgery Department, Portuguese Red Cross Hospital, Lisbon, Portugal., Leon G; 1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola., Magalhães MP; 1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.; 4 Pediatric Cardiology Department, Cardiac Surgery Department, Portuguese Red Cross Hospital, Lisbon, Portugal., Martins T; 1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola., Júnior APF; 1 Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola. |
| المصدر: | World journal for pediatric & congenital heart surgery [World J Pediatr Congenit Heart Surg] 2019 Mar; Vol. 10 (2), pp. 164-170. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Publications Country of Publication: United States NLM ID: 101518415 Publication Model: Print Cited Medium: Internet ISSN: 2150-136X (Electronic) Linking ISSN: 21501351 NLM ISO Abbreviation: World J Pediatr Congenit Heart Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Thousand Oaks, CA : Sage Publications |
| مواضيع طبية MeSH: | Blalock-Taussig Procedure* , Fontan Procedure*, Heart Defects, Congenital/*surgery , Heart Ventricles/*abnormalities , Pulmonary Artery/*surgery, Angola ; Female ; Heart Defects, Congenital/mortality ; Heart Ventricles/surgery ; Humans ; Infant ; Infant, Newborn ; Kaplan-Meier Estimate ; Male ; Palliative Care/methods ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | Introduction: Single ventricle physiology management is challenging, especially in low-income countries. Objective: To report the palliation outcomes of single ventricle patients in a developing African country. Methods: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock-Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). Results: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 ± 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P = .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P = .002) impacted survival. Conclusion: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required. |
| التعليقات: | Comment in: World J Pediatr Congenit Heart Surg. 2019 Mar;10(2):171-173. (PMID: 30841827) |
| فهرسة مساهمة: | Keywords: Blalock–Taussig shunt; Fontan procedure; Glenn procedure; pulmonary artery banding; single ventricle |
| تواريخ الأحداث: | Date Created: 20190308 Date Completed: 20190607 Latest Revision: 20190607 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1177/2150135118822671 |
| PMID: | 30841832 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2150-136X |
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| DOI: | 10.1177/2150135118822671 |