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.
Article
Dans Anglais
| 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>
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Anatomopathologie
/
Chirurgie générale
/
Pontage cardiopulmonaire
/
Circulation pulmonaire
/
Études rétrospectives
/
Résultat thérapeutique
/
Procédure de Fontan
/
Cardiopathies congénitales
/
Poumon
/
Méthodes
Type d'étude:
Étude observationnelle
Limites du sujet:
Enfant
/
Enfant d'âge préscolaire
/
Femelle
/
Humains
/
Bébé
/
Mâle
langue:
Anglais
Texte intégral:
Chinese Medical Journal
Année:
2009
Type:
Article
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