Preoperative N-terminal pro-brain natriuretic peptide is associated with Fontan outcomes.
J Thorac Cardiovasc Surg
; 164(3): 770-780.e3, 2022 09.
Article
en En
| MEDLINE
| ID: mdl-35031137
ABSTRACT
OBJECTIVE:
The role of preoperative N-terminal pro-brain natriuretic peptide level in patient outcomes after the Fontan operation remains unclear.METHODS:
The medical records of all patients who underwent their first Fontan operation from June 2011 to October 2019 in our tertiary referral pediatric cardiac center were retrospectively reviewed. Preoperative hemodynamic factors and N-terminal pro-brain natriuretic peptide were analyzed to test the association of mortality and morbidity.RESULTS:
We enrolled 110 patients (men/women 62/48; median age, 4.1 [3.4, 5.8] years; median follow-up period, 4.28 [2.31, 6.71] years). Almost all operations were extracardiac conduits (98.2%). Primary outcomes of death, Fontan takedown, and heart transplantation were observed in 9 patients (8.2%). Abnormal ventricular contractility, elevated preoperative pulmonary artery pressure, high pulmonary vascular resistance index, and high log10 N-terminal pro-brain natriuretic peptide level were associated with poor outcomes. SECONDARYOUTCOMES:
atrioventricular valve regurgitation moderate or greater, elevated pulmonary artery pressure, high pulmonary vascular resistance index, and high log10 N-terminal pro-brain natriuretic peptide level were associated with rehospitalization due to heart failure. Multivariable Cox regression analysis revealed that log10 N-terminal pro-brain natriuretic peptide was the only significant predictor of all primary and secondary outcomes. A scoring system including factors of pulmonary artery pressure, pulmonary vascular resistance index, and N-terminal pro-brain natriuretic peptide was established, and the risk stratification is associated with outcomes after the Fontan operation.CONCLUSIONS:
High preoperative N-terminal pro-brain natriuretic peptide was associated with poor outcomes after the Fontan operation.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Procedimiento de Fontan
/
Cardiopatías Congénitas
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Child
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Child, preschool
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Año:
2022
Tipo del documento:
Article
País de afiliación:
Taiwán