PMID- 28543642
OWN - NLM
STAT- MEDLINE
DCOM- 20171005
LR  - 20171005
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 32
IP  - 6
DP  - 2017 Jun
TI  - Bidirectional superior cavopulmonary anastomosis with or without cardiopulmonary 
      bypass: A randomized study.
PG  - 376-381
LID - 10.1111/jocs.13149 [doi]
AB  - OBJECTIVES: This study aims to compare the bidirectional superior cavopulmonary 
      anastomosis (BDG) with or without cardiopulmonary bypass (CPB). METHODS: 100 
      patients undergoing BDG were randomized into two groups: Off-CPB or on-CPB 
      groups. All patients underwent near-infrared spectrophotometry (NIRS) and 
      bispectral index (BIS) monitoring and pre- and postoperative serum 100 beta 
      protein measurements (Sbeta100) and neuro-cognitive evaluation. Postoperative 
      intensive care unit (ICU) parameters were also studied. RESULTS: The median age 
      of patients in the on-CPB and off-CPB group were 42 and 48 months, respectively 
      (p = 0.11). Median weights in the on-CPB group and off-CPB group were 13.5 (5-50) 
      kg and 15 (7-36) kg, respectively (p = 0.927). There was a significant rise in 
      superior vena cava (SVC) pressure on SVC clamping in the off-CPB group 
      (23.12 +/- 6.84 vs 2.98 +/- 2.22 mmHg) on-CPB group (p < 0.001). There was a 
      significant fall in NIRS and BIS values from baseline in the off-CPB group during 
      the anastomosis but there was no statistically significant change in serum 
      Sbeta100from pre-clamp to post-clamp in either group. Inotropic support, duration of 
      ventilation, ICU stay, and hospital stay were significantly less in the off-CPB 
      group (p < 0.001). Assessment of Social Adaptive Functioning revealed no adverse 
      sequelae. There were significant cost savings if surgery was performed off-CPB 
      (p < 0.001). CONCLUSION: Off CPB-BDG is an economical and safe procedure. 
      Duration of inotropic and mechanical ventilatory support, ICU, and hospital stay 
      is significantly less. We did not observe any early adverse neurologic sequelae 
      in patients undergoing off-CPB BDG.
CI  - (c) 2017 Wiley Periodicals, Inc.
FAU - Talwar, Sachin
AU  - Talwar S
AUID- ORCID: 0000-0002-9063-7691
AD  - Departments of Cardiothoracic and Vascular Surgery, All India Institute of 
      Medical Sciences, New Delhi, India.
FAU - Gupta, Anish
AU  - Gupta A
AD  - Departments of Cardiothoracic and Vascular Surgery, All India Institute of 
      Medical Sciences, New Delhi, India.
FAU - Nehra, Ashima
AU  - Nehra A
AD  - Clinical Neuropsychology, Neurosciences Centre, All India Institute of Medical 
      Sciences, New Delhi, India.
FAU - Makhija, Neeti
AU  - Makhija N
AD  - Departments of Cardiac Anaesthesiology, All India Institute of Medical Sciences, 
      New Delhi, India.
FAU - Kapoor, Poonam Malhotra
AU  - Kapoor PM
AD  - Departments of Cardiac Anaesthesiology, All India Institute of Medical Sciences, 
      New Delhi, India.
FAU - Sreenivas, Vishnubhatla
AU  - Sreenivas V
AD  - Departments of Biostatistics, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Choudhary, Shiv Kumar
AU  - Choudhary SK
AD  - Departments of Cardiothoracic and Vascular Surgery, All India Institute of 
      Medical Sciences, New Delhi, India.
FAU - Airan, Balram
AU  - Airan B
AD  - Departments of Cardiothoracic and Vascular Surgery, All India Institute of 
      Medical Sciences, New Delhi, India.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20170521
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Anastomosis, Surgical/*methods
MH  - *Cardiopulmonary Bypass
MH  - Cardiovascular Surgical Procedures/*methods
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Heart Septal Defects, Ventricular/*surgery
MH  - Humans
MH  - Infant
MH  - Intensive Care Units
MH  - Length of Stay
MH  - Male
MH  - Prospective Studies
MH  - Pulmonary Artery/*surgery
MH  - Respiration, Artificial/statistics & numerical data
MH  - Treatment Outcome
MH  - Vena Cava, Superior/*surgery
OTO - NOTNLM
OT  - bidirectional glenn
OT  - cardiopulmonary bypass
OT  - univentricular heart
EDAT- 2017/05/26 06:00
MHDA- 2017/10/06 06:00
CRDT- 2017/05/26 06:00
PHST- 2017/05/26 06:00 [pubmed]
PHST- 2017/10/06 06:00 [medline]
PHST- 2017/05/26 06:00 [entrez]
AID - 10.1111/jocs.13149 [doi]
PST - ppublish
SO  - J Card Surg. 2017 Jun;32(6):376-381. doi: 10.1111/jocs.13149. Epub 2017 May 21.