Abstract |
The object of our study was to analyze the results of bidirectional cavopulmonary anastomosis (BCPA) and modified Fontan operations (MFO) in patients with a functionally single ventricle and heterotaxy syndrome and to reveal risk factors for these surgical interventions. During 1983-2010, 681 patients underwent BCPA or MFO. Thirty-nine had heterotaxy syndrome. The median follow-up period after BCPA and MFO was nine and 1.5 years, respectively. Risk factors for lethal outcomes were determined by logistic regression analysis. Hospital mortality after BCPA and MFO was 7.9% and 12.5%, respectively and did not significantly differ from patients without heterotaxy. The most frequent hospital complications were heart failure, pleural effusions, and arrhythmias. Late mortality after BCPA and MFO was 8.7% and did not significantly differ from patients without heterotaxy. Late deaths were caused by congestive heart failure or pulmonary thromboembolism. The main non-lethal complication was arrhythmia. Patients have significantly improved their functional class at follow-up. The independent risk factor for lethal outcomes after BCPA and MFO was preoperative regurgitation at atrioventricular valves (P=0.012). BCPA and MFO in patients with a functionally single ventricle and heterotaxy syndrome allow to significantly improves their quality of life. Preoperative regurgitation at atrioventricular valves worsens surgical results.
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Authors | Ivan A Yurlov, Vladimir P Podzolkov, Mikhail M Zelenikin, Dmitry V Kovalev, Guvandg K Babaev, Neele A Putiato, Sergey B Zaets |
Journal | Interactive cardiovascular and thoracic surgery
(Interact Cardiovasc Thorac Surg)
Vol. 12
Issue 4
Pg. 563-8
(Apr 2011)
ISSN: 1569-9285 [Electronic] England |
PMID | 21233261
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Abnormalities, Multiple
- Adolescent
- Adult
- Analysis of Variance
- Chi-Square Distribution
- Child
- Child, Preschool
- Dextrocardia
(complications, mortality, physiopathology)
- Fontan Procedure
(adverse effects, mortality)
- Genetic Diseases, X-Linked
(complications, mortality, physiopathology)
- Heart Defects, Congenital
(complications, mortality, physiopathology, surgery)
- Heart Ventricles
(abnormalities, physiopathology, surgery)
- Heterotaxy Syndrome
- Hospital Mortality
- Humans
- Infant
- Kaplan-Meier Estimate
- Logistic Models
- Odds Ratio
- Recovery of Function
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Russia
- Situs Inversus
(complications, mortality, physiopathology)
- Time Factors
- Treatment Outcome
- Young Adult
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