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Identification of patient variables that are associated with ventricular end-diastolic pressure before the bidirectional Glenn operation
- Source :
- Cardiology in the Young. 31:1644-1650
- Publication Year :
- 2021
- Publisher :
- Cambridge University Press (CUP), 2021.
-
Abstract
- Introduction:Systemic ventricular end-diastolic pressure is important in patients with single ventricle heart disease. Predictors of an elevated systemic ventricular end-diastolic pressure prior to bidirectional Glenn operation have been incompletely identified.Methods:All patients who underwent bidirectional Glenn operation operation at our centre between January 2007 and March 2017 were retrospectively identified and patient variables were extracted. For patients who had undergone Fontan operation at the time of this study, post-Fontan patient variables were also extracted.Results:One-hundred patients were included with a median age at pre-bidirectional Glenn operation catheterisation of 4.5 months. In total, 71 (71%) patients had a systemic right ventricle. At the pre-bidirectional Glenn operation catheterisation, the mean systemic ventricular end-diastolic pressure was higher amongst those with systemic right ventricle compared to left ventricle (9.1 mmHg ± 2.1 versus 7.7 ± 2.7 mmHg, p < 0.01). On univariate analysis, pre-bidirectional Glenn operation systemic ventricular end-diastolic pressure was positively associated with the presence of a systemic right ventricle (p < 0.01), history of recoarctation (p = 0.03), history of Norwood operation (p = 0.04), and ventricular systolic pressure (p < 0.01). On multivariate analysis, systemic ventricular end-diastolic pressure was positively associated with the presence of a systemic right ventricle (p < 0.01) and ventricular systolic pressure (p < 0.01). Amongst those who had undergone Fontan operation at the time of study (n = 49), those with a higher pre-bidirectional Glenn operation systemic ventricular end-diastolic pressure were more likely to have experienced death, transplantation, or listed for transplantation (p = 0.02) and more likely to have had heart failure symptoms (p = 0.04) at a mean time from Fontan of 5.2 years ± 1.3.Conclusions:In patients undergoing bidirectional Glenn operation operation, the volume-loaded, pre-bidirectional Glenn operation state may expose diastolic dysfunction that has prognostic value.
- Subjects :
- medicine.medical_specialty
Heart Ventricles
Diastole
Blood Pressure
030204 cardiovascular system & hematology
Fontan Procedure
Norwood Procedures
03 medical and health sciences
0302 clinical medicine
Internal medicine
Ventricular Pressure
medicine
Humans
Retrospective Studies
Univariate analysis
business.industry
Infant
General Medicine
medicine.disease
Norwood Operation
Transplantation
Treatment Outcome
Blood pressure
medicine.anatomical_structure
030228 respiratory system
Ventricle
Heart failure
Pediatrics, Perinatology and Child Health
Cardiology
End-diastolic volume
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 14671107 and 10479511
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Cardiology in the Young
- Accession number :
- edsair.doi.dedup.....d2ebaf8209f2fed3764da261ed88e164