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Outcomes Following Heterotopic Placement of Right Ventricle to Pulmonary Artery Conduits
- Source :
- World Journal for Pediatric and Congenital Heart Surgery. 12:220-229
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- Background: We sought to evaluate the outcomes following right ventricle to pulmonary artery (RV-PA) conduit placement in pediatric patients, excluding those with a RV-PA conduit for the Ross procedure which is associated with improved conduit durability, partly related to its orthotopic position. Methods: Outcomes for 119 patients who underwent RV-PA conduit placement at a single institution from January 2004 to December 2016 were reviewed. Primary outcome measures were reintervention-free survival (RFS) and overall survival. Survival analyses were performed using the Kaplan-Meier method, and risk factors associated with reintervention were evaluated. Results: The median age at the time of conduit placement was 6 months (interquartile range, IQR: 1-14), and the median length of follow-up was 63 months (range: 0-156). During follow-up, 39 patients required conduit-related reintervention, while 6 patients died perioperatively with an overall survival of 90% at 10 years. Among the remaining 113 patients, the RFS at one, five, and ten years was 91% (84%-95%), 72% (60%-80%), and 33% (16%-50%), respectively. The median time to conduit replacement in the series was 43.5 months (IQR: 19.3-76.2). The use of a pulmonary homograft was associated with improved RFS ( P = .03), and this was particularly pronounced in comparison with aortic homografts in neonates. Infection was the indication for replacement in only one patient. Conclusions: The majority of the conduits placed during the neonatal period required conduit replacement before the age of five years. Endocarditis was not a common indication for replacement. In neonates and infants, we prefer pulmonary homografts for most indications.
- Subjects :
- Heart Defects, Congenital
Male
medicine.medical_specialty
Heart Ventricles
Pulmonary Artery
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Electrical conduit
Internal medicine
medicine.artery
Humans
Medicine
Cardiac Surgical Procedures
business.industry
Infant, Newborn
Infant
General Medicine
Treatment Outcome
medicine.anatomical_structure
Ventricle
Child, Preschool
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Pulmonary artery
Cardiology
Truncus arteriosus communis
Female
Surgery
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 2150136X and 21501351
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- World Journal for Pediatric and Congenital Heart Surgery
- Accession number :
- edsair.doi.dedup.....ee257d6dbd4ce504350440a34059edf9