Outcomes and prognostic factors for postsurgical pulmonary vein stenosis in the current era
| العنوان: | Outcomes and prognostic factors for postsurgical pulmonary vein stenosis in the current era |
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| المؤلفون: | Kalfa, D., Belli, E., Bacha, E., Lambert, V., Carlo, D. di, Kostolny, M., Nosal, M., Horer, J., Salminen, J., Rubay, J., Yemets, I., Hazekamp, M., Maruszewski, B., Sarris, G., Berggren, H., Ebels, T., Baser, O., Lacour-Gayet, F., European Congenital Heart Surg |
| المساهمون: | Cardiothoracic Surgery, Cardiovascular Centre (CVC), Children's Hospital, Clinicum, University of Helsinki, HUS Children and Adolescents |
| المصدر: | Journal of thoracic and cardiovascular surgery, 156(1), 278-286. Mosby Inc. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 156(1), 278-286. MOSBY-ELSEVIER The Journal of Thoracic and Cardiovascular Surgery, 156(1), 278-286 |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, Time Factors, medicine.medical_treatment, 030204 cardiovascular system & hematology, outcomes, Severity of Illness Index, Pulmonary vein, pulmonary vein stenosis, 0302 clinical medicine, Restenosis, Recurrence, Risk Factors, Interquartile range, PERICARDIUM, Child, Pulmonary vein stenosis, Endarterectomy, IN-SITU, Hazard ratio, congenital heart disease, Sutureless Surgical Procedures, 3. Good health, Europe, Treatment Outcome, Pulmonary Veins, Child, Preschool, SURVIVAL, Female, sutureless repair, Cardiology and Cardiovascular Medicine, VENOUS CONNECTION, Reoperation, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, STRATEGIES, 03 medical and health sciences, medicine.artery, MANAGEMENT, medicine, Humans, Cardiac Surgical Procedures, Risk factor, Vascular Patency, Retrospective Studies, business.industry, Infant, Newborn, Infant, 3126 Surgery, anesthesiology, intensive care, radiology, SURGICAL REPAIR, medicine.disease, Surgery, SEVERITY, Stenosis, Pulmonary Vein, 030228 respiratory system, 3121 General medicine, internal medicine and other clinical medicine, North America, Pulmonary artery, business, SINGLE-INSTITUTION |
| الوصف: | Background: The optimal management and prognostic factors of postsurgical pulmonary vein stenosis remain controversial. We sought to determine current postsurgical pulmonary vein stenosis outcomes and prognostic factors in a multicentric study in the current era. Methods: Seventy-five patients with postsurgical pulmonary vein stenosis who underwent 103 procedures in 14 European/North American centers (2000-2012) were included retrospectively. A specific pulmonary vein stenosis severity score was developed on the basis of the assessment of each pulmonary vein. End points were death, pulmonary vein reintervention, and restenosis. A univariate and multivariate risk analysis was performed. Results: Some 76% of postsurgical pulmonary vein stenosis occurred after repair of a total anomalous pulmonary venous return. Sutureless repair was used in 42 of 103 procedures (41%), patch veinoplasty was used in 28 procedures (27%), and endarterectomy was used in 16 procedures (16%). Overall pulmonary vein restenosis, reintervention, and mortality occurred in 56% (n = 58/103), 49% (n = 50/103), and 27% (n = 20/75), respectively. Sutureless repair was associated with less restenosis (40% vs 67%; P =.007) and less reintervention (31% vs 61%; P =.003). Mortality after sutureless repair (20%; 7/35) tends to be lower than after nonsutureless repair (33%; 13/40) (P =.22). A high postoperative residual pulmonary vein stenosis score at the time of hospital discharge was an independent risk factor for restenosis (hazard ratio [HR], 1.55; P < 10−4), reintervention (HR, 1.33; P < 10−4), and mortality (HR, 1.37; P < 10−4). The sutureless technique was an independent protective factor against restenosis (HR, 0.27; P =.006). Conclusions: Postsurgical pulmonary vein stenosis still has a guarded prognosis in the current era. The sutureless technique is an independent protective factor against restenosis. The severity of the residual disease evaluated by a new severity score is an independent risk factor for poor outcomes regardless of surgical technique. |
| اللغة: | English |
| تدمد: | 0022-5223 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f98426ff5aff5936dc5b80682f29af57 https://hdl.handle.net/1887/96041 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....f98426ff5aff5936dc5b80682f29af57 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 00225223 |
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