Survival After Intervention for Single-Ventricle Heart Disease Over 15 Years at a Single Institution.
| Title: | Survival After Intervention for Single-Ventricle Heart Disease Over 15 Years at a Single Institution. |
|---|---|
| Authors: | Zhu A; Department of Surgery, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, North Carolina.; Meza JM; Department of Surgery, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, North Carolina.; Prabhu NK; Department of Surgery, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, North Carolina.; McCrary AW; Department of Pediatrics, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, North Carolina.; Allareddy V; Department of Pediatrics, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, North Carolina.; Turek JW; Department of Surgery, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, North Carolina.; Andersen ND; Department of Surgery, Duke Children's Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, North Carolina. Electronic address: nicholas.andersen@duke.edu. |
| Source: | The Annals of thoracic surgery [Ann Thorac Surg] 2022 Dec; Vol. 114 (6), pp. 2303-2312. Date of Electronic Publication: 2022 Apr 14. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 15030100R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6259 (Electronic) Linking ISSN: 00034975 NLM ISO Abbreviation: Ann Thorac Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam : Elsevier; Original Publication: Boston. |
| MeSH Terms: | Heart Defects, Congenital*/surgery ; Norwood Procedures* ; Hypoplastic Left Heart Syndrome* ; Univentricular Heart*; Pulmonary Artery/surgery ; Child ; Humans ; Treatment Outcome ; Heart Ventricles ; Palliative Care ; Retrospective Studies |
| Abstract: | Background: Children with single-ventricle (SV) heart disease possess a spectrum of heart malformations, yet progress through similar hemodynamic states, suggesting differences in outcomes are related to fundamental morphologic differences, patient characteristics, or procedural pathways. We sought to provide a holistic overview of survival after intervention for SV heart disease at our institution.; Methods: SV heart disease was defined as patients born with a hypoplastic or dysfunctional ventricle with uncertain or unacceptable candidacy for a 2-ventricle circulation. Patients were stratified into 8 diagnostic groups and 11 procedural categories based on the initial interventional procedure.; Results: Between 2005 and 2020, 381 patients born with SV heart disease underwent intervention at our institution. Ten-year survival was highest for patients with double inlet left ventricle (89% ± 7%) and lowest for patients with hypoplastic left heart syndrome (55% ± 5%). Initial palliation with less invasive procedures, such as ductal stent (4-year: 100%) or pulmonary artery banding (10-year: 95% ± 5%), demonstrated superior survival compared with more invasive procedures such as the Norwood procedure (10-year: 59% ± 4%). Survival of patients who achieved a biventricular circulation was superior to patients who remained with SV physiology (10-year: 87% ± 5% vs 63% ± 3%, P = .04). In a multivariable analysis, chromosomal/syndromic abnormality, lower weight, hybrid Norwood procedure, nonleft ventricular dominance, and earlier year of operation were risk factors for death.; Conclusions: Survival differences in patients with SV heart disease were related primarily to underlying cardiac anatomy, patient characteristics, and procedural complexity. Left ventricular dominance, more recent intervention, and attainment of a 2-ventricle circulation were associated with improved survival.; (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.) |
| Comments: | Comment in: Ann Thorac Surg. 2022 Dec;114(6):2312-2313. doi: 10.1016/j.athoracsur.2022.04.037.. (PMID: 35513048) |
| Entry Date(s): | Date Created: 20220417 Date Completed: 20221129 Latest Revision: 20221229 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.athoracsur.2022.03.060 |
| PMID: | 35430225 |
| Database: | MEDLINE |
Journal Article