PMID- 28453799
OWN - NLM
STAT- MEDLINE
DCOM- 20170919
LR  - 20181202
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 24
IP  - 5
DP  - 2017 May 1
TI  - Early to mid-term results after total cavopulmonary connection performed in the 
      second decade of life.
PG  - 762-767
LID - 10.1093/icvts/ivw427 [doi]
AB  - OBJECTIVES: Total cavopulmonary connection (TCPC) performed in the second decade 
      of life has rarely been studied. Thus, we investigated (bicentric study) early 
      and late morbidity and mortality following completion of TCPC in these patients. 
      METHODS: From January 1999 to June 2014, 63 patients (14.5 +/- 2.9 years) underwent 
      TCPC (extracardiac conduit). Palliation before completion was an isolated 
      bidirectional cavopulmonary shunt (BCPS) in 3 patients or BCPS associated with 
      additional pulmonary blood flow (APBF) that was either antegrade (Group 1) in 38 
      (63%) or retrograde (Group 2) in 22 (37%). Preoperative and perioperative data 
      were reviewed retrospectively. RESULTS: Mean pulmonary arterial and ventricular 
      end-diastolic pressures were 12.2 and 9.2 mmHg, respectively. Mean Nakata index 
      was 279 +/- 123 and 228 +/- 87 mm 2 /m 2 in Groups 1 and 2, respectively ( P  =   
      0.01). Aortic cross-clamping was performed in 22 from Group 1 and 8 from Group 2 
      ( P  =   0.04). Mean follow-up was 4.57 years [0.8-15]. Nine patients had 
      prolonged stays in the intensive care unit (>6 days). There were 1 early and 2 
      late deaths (non-cardiac related). Actuarial survival was 96% at 4 years. At last 
      follow-up, single-ventricle function remained normal or improved in all patients 
      (Group 1) compared to 82% in Group 2 ( P  =   0.02). New York Heart Association 
      (NYHA) class had improved in both groups: 47 patients were NYHA class II and 16 
      class III preoperatively vs 50 class I and 10 class II postoperatively ( P  <   
      0.001). CONCLUSIONS: Single-ventricle palliation with BCPS and APBF allowed 
      completion of TCPC in the second decade of life, with encouraging mid-term 
      results. However, BCPS with retrograde APBF was associated with single-ventricle 
      dysfunction: thus, this technique needs to be used cautiously as long-lasting 
      palliation.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of the European 
      Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Metras, Alexandre
AU  - Metras A
AD  - Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, 
      University of Bordeaux II, France.
FAU - Fouilloux, Virginie
AU  - Fouilloux V
AD  - Department of Cardiothoracic Surgery, Children's Hospital La Timone, Marseille, 
      France.
FAU - Al-Yamani, Mohammed
AU  - Al-Yamani M
AD  - Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, 
      University of Bordeaux II, France.
FAU - Roques, Xavier
AU  - Roques X
AD  - Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, 
      University of Bordeaux II, France.
FAU - Mace, Loic
AU  - Mace L
AD  - Department of Pediatric Cardiology, Bordeaux Heart University Hospital, 
      University of Bordeaux II, France.
FAU - Thambo, Jean-Benoit
AU  - Thambo JB
AD  - Department of Pediatric Cardiology, Bordeaux Heart University Hospital, 
      University of Bordeaux II, France.
FAU - Metras, Dominique
AU  - Metras D
AD  - Department of Cardiothoracic Surgery, Children's Hospital La Timone, Marseille, 
      France.
FAU - Kreitmann, Bernard
AU  - Kreitmann B
AD  - Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, 
      University of Bordeaux II, France.
FAU - Roubertie, Francois
AU  - Roubertie F
AD  - Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, 
      University of Bordeaux II, France.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Adolescent
MH  - Female
MH  - Follow-Up Studies
MH  - Fontan Procedure/*methods
MH  - France/epidemiology
MH  - Heart Defects, Congenital/mortality/physiopathology/*surgery
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - CHD
OT  - Congenital heart disease
OT  - Fontan
OT  - Outcomes
OT  - Univentricular heart
EDAT- 2017/04/30 06:00
MHDA- 2017/09/20 06:00
CRDT- 2017/04/29 06:00
PHST- 2016/08/01 00:00 [received]
PHST- 2016/11/23 00:00 [accepted]
PHST- 2017/04/29 06:00 [entrez]
PHST- 2017/04/30 06:00 [pubmed]
PHST- 2017/09/20 06:00 [medline]
AID - ivw427 [pii]
AID - 10.1093/icvts/ivw427 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2017 May 1;24(5):762-767. doi: 
      10.1093/icvts/ivw427.