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Impact of Extracardiac Anomalies on Mortality and Morbidity in Staged Single Ventricle Palliation.

Authors :
Vodiskar, Janez
Mertin, Jannik
Heinisch, Paul Philipp
Burri, Melchior
Kido, Takashi
Strbad, Martina
Hager, Alfred
Ewert, Peter
Hörer, Jürgen
Ono, Masamichi
Source :
Annals of Thoracic Surgery; May2023, Vol. 115 Issue 5, p1197-1204, 8p
Publication Year :
2023

Abstract

This study was intended to determine the impact of extracardiac anomalies on outcomes in patients with functional single ventricle who underwent staged palliation. We reviewed medical records of patients who underwent first-stage palliation at our center between 2001 and 2020. The prevalence and type of extracardiac anomalies were evaluated, and their impact on outcomes during staged palliation was analyzed. Among 602 patients who underwent first-stage palliation, 81 (14%) patients had associated with extracardiac anomalies. They were more frequently associated with prematurity (P =.03) and low birth weight below 2.5 kg (P <.01). Mortality between first-stage palliation and stage II was similar in patients with and without extracardiac anomalies (24.7% vs 17.1%, P =.10). However, mortality between stage II and stage III was significantly higher in patients with extracardiac anomalies compared with those without (22.2% vs 12.5%, P =.02). Mortality after stage III was also higher in patients with extracardiac anomalies compared with those without (4.9% vs 1.5%, P =.04). In the subgroup analysis of 81 patients with extracardiac anomalies, renal anomalies were identified as a significant risk factor for mortality (P =.03, hazard ratio 2.44). The incidence of extracardiac anomalies in this study was 14%, and patients with extracardiac anomalies were highly associated with prematurity and low birth weight. Presence of extracardiac anomalies was associated with higher mortality between stage II and stage III palliation and after stage III phase, but not before stage II. Among extracardiac anomalies, renal anomalies were identified as a risk factor for mortality. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00034975
Volume :
115
Issue :
5
Database :
Supplemental Index
Journal :
Annals of Thoracic Surgery
Publication Type :
Academic Journal
Accession number :
163163811
Full Text :
https://doi.org/10.1016/j.athoracsur.2023.01.013