Mid-Term Outcomes After Unifocalization Guided by Intraoperative Pulmonary Flow Study
| العنوان: | Mid-Term Outcomes After Unifocalization Guided by Intraoperative Pulmonary Flow Study |
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| المؤلفون: | Doff B. McElhinney, Kathleen R. Ryan, Yulin Zhang, Michael Ma, Ariana Goodman, Ozzie Jahadi, Frank L. Hanley, Lisa Wise-Faberowski |
| المصدر: | World Journal for Pediatric and Congenital Heart Surgery. 12:76-83 |
| بيانات النشر: | SAGE Publications, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, Pulmonary Circulation, medicine.medical_specialty, Time Factors, Heart Ventricles, Collateral Circulation, Pulmonary Artery, 030204 cardiovascular system & hematology, Intracardiac injection, law.invention, Intraoperative Period, 03 medical and health sciences, 0302 clinical medicine, law, Internal medicine, medicine.artery, medicine, Cardiopulmonary bypass, Humans, Cardiac Surgical Procedures, Pulmonary flow, Tetralogy of Fallot, business.industry, Infant, General Medicine, medicine.disease, 030228 respiratory system, Pulmonary Atresia, Child, Preschool, Pediatrics, Perinatology and Child Health, Pulmonary artery, Cardiology, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies |
| الوصف: | Background: Repair of tetralogy of Fallot (TOF) with major aortopulmonary collateral arteries (MAPCAs) requires unifocalization of pulmonary circulation, intracardiac repair with the closure of the ventricular septal defect, and placement of a right ventricle (RV) to pulmonary artery (PA) conduit. The decision to perform complete repair is sometimes aided by an intraoperative flow study to estimate the total resistance of the reconstructed pulmonary circulation. Methods: We reviewed patients who underwent unifocalization and PA reconstruction for TOF/MAPCAs to evaluate acute and mid-term outcomes after repair with and without flow studies and to characterize the relationship between PA pressure during the flow study and postrepair RV pressure. Results: Among 579 patients who underwent unifocalization and PA reconstruction for TOF/MAPCAs, 99 (17%) had an intraoperative flow study during one (n = 91) or more (n = 8) operations to determine the suitability for a complete repair. There was a reasonably good correlation between mean PA pressure at 3 L/min/m2 during the flow study and postrepair RV pressure and RV:aortic pressure ratio. Acute and mid-term outcomes (median: 3.8 years) after complete repair in the flow study patients (n = 78) did not differ significantly from those in whom the flow study was not performed (n = 444). Furthermore, prior failed flow study was not associated with differences in outcome after subsequent intracardiac repair. Conclusions: The intraoperative flow study remains a useful adjunct for determining the suitability for complete repair in a subset of patients undergoing surgery for TOF/MAPCAs, as it is reasonably accurate for estimating postoperative PA pressure and serves as a reliable guide for the feasibility of single-stage complete repair. |
| تدمد: | 2150-136X 2150-1351 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a61baef4607c1cf2ad7539d2bfd7b331 https://doi.org/10.1177/2150135120964427 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....a61baef4607c1cf2ad7539d2bfd7b331 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 2150136X 21501351 |
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