Back to Search
Start Over
Impact of aorto-pulmonary and veno-venous collaterals on the onset of plastic bronchitis following the Fontan procedure.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2024 Oct 07. Date of Electronic Publication: 2024 Oct 07. - Publication Year :
- 2024
- Publisher :
- Ahead of Print
-
Abstract
- Objective: This study aimed to clarify the association of the aorto-pulmonary/veno-venous collaterals in patients with plastic bronchitis after the Fontan procedure.<br />Methods: All patients who underwent total cavopulmonary connection from 1994 to 2022 were reviewed. Aorto-pulmonary/veno-venous collaterals were detected using angiograms. The impact of aorto-pulmonary/veno-venous collaterals as well as other variables on the onset of plastic bronchitis were evaluated.<br />Results: A total of 635 patients were included. Plastic bronchitis was observed in 15 (2.4%) patients and the median duration between total cavopulmonary connection and the onset of plastic bronchitis was 1.1 years. Freedom from plastic bronchitis at 5 and 10 years was 97.5 and 96.5%, respectively. As for the association of PB and APCs/VVCs, patients with PB had an increased incidence of post-TCPC APCs (60 vs. 14%, p<0.001) and VVCs (53 vs. 14%, p<0.001). The freedom from plastic bronchitis was the lowest in the patients who were associated with both aortopulmonary collaterals and veno-venous collaterals after total cavopulmonary connection. Aortopulmonary collaterals after total cavopulmonary connection (p=0.002, hazard ratio: 5.729), veno-venous collaterals after total cavopulmonary connection (p=0.016, hazard ratio: 3.527), and chylothorax (p=0.019, hazard ratio: 3.662) were identified as independently associated factors with the onset of plastic bronchitis.<br />Conclusions: The occurrence of post-Fontan aortopulmonary and veno-venous collaterals was significantly associated with the development of plastic bronchitis. Treatment or mitigation of collaterals may represent an opportunity to prevent the development of plastic bronchitis, a remaining source of post-Fontan excess morbidity and mortality.<br /> (Copyright © 2024. Published by Elsevier Inc.)
Details
- Language :
- English
- ISSN :
- 1097-685X
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 39384081
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2024.09.049