Bilateral bidirectional superior cavopulmonary shunt is more beneficial in medium and long term clinical outcomes than unilateral shunt / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 129-135, 2009.
Artículo
en Inglés
| WPRIM
| ID: wpr-265861
ABSTRACT
<p><b>BACKGROUND</b>The present study was aimed to compare the effects of bilateral and unilateral bidirectional superior cavopulmonary shunt (b-BDG and u-BDG) on pulmonary artery growth and clinical outcomes.</p><p><b>METHODS</b>The 51 subjects enrolled in this study were divided into two groups those receiving b-BDG (n = 21) and those receiving u-BDG (n = 30). Clinical records were reviewed retrospectively at a mean of 43.3 months after BDG procedures. Chi square and t-tests were performed to analyze the data.</p><p><b>RESULTS</b>Left and right pulmonary artery diameters increased 27% - 37% in both groups. The pulmonary artery index increased 37.2% after b-BDG and 27.0% after u-BDG. b-BDG patients experienced a significant decrease in mean hemoglobin concentration and hematocrit value, and a correlated change in postoperative diameter of left pulmonary artery (LPA) and pulmonary artery index (y = 0.2719, x = -1.8278; R = 0.564, P = 0.008). The change ratio of hemoglobin and postoperative LPA were also correlated in b-BDG patients (y = -0.0522x + 0.3539; R = -0.479, P = 0.028). Only one b-BDG patient versus twelve u-BDG patients needed total cavopulmonary connections 31.8 months after BDG surgery (P = 0.0074). Moreover, only one (4.8%) b-BDG patient but eight u-BDG patients (26.7%) developed pulmonary arteriovenous malformations.</p><p><b>CONCLUSIONS</b>b-BDG increases bilateral pulmonary blood flow and promotes growth of bilateral pulmonary arteries, with preferable physiological outcomes to u-BDG. Results may imply that subsequent Fontan repair may not always be needed.</p>
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Patología
/
Cirugía General
/
Puente Cardiopulmonar
/
Circulación Pulmonar
/
Estudios Retrospectivos
/
Resultado del Tratamiento
/
Procedimiento de Fontan
/
Cardiopatías Congénitas
/
Pulmón
/
Métodos
Tipo de estudio:
Estudio observacional
Límite:
Niño
/
Child, preschool
/
Femenino
/
Humanos
/
Lactante
/
Masculino
Idioma:
Inglés
Revista:
Chinese Medical Journal
Año:
2009
Tipo del documento:
Artículo
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