Risk factors for death or heart transplantation in single-ventricle physiology (tricuspid atresia, pulmonary atresia, and heterotaxy): A systematic review and meta-analysis.
J Heart Lung Transplant
; 38(7): 739-747, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-31006521
ABSTRACT
BACKGROUND:
In this study we sought to evaluate risk factors (RFs) for death or heart transplantation (D-HT) in single-ventricle (SV) physiology due to tricuspid atresia (TA), pulmonary atresiaâintact ventricular septum (PA-IVS), and heterotaxy with SV (HX), clinical conditions for which outcome data are limited.METHODS:
To conduct a systematic review, we included citations that evaluated occurrence of D-HT in SV physiology of TA, PA-IVS, and HX in English articles published between January 1998 and December 2017 based on inclusion and exclusion criteria, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The Cochrane Risk of Bias in Non-Randomized Studies-Interventions (ROBINS-I) tool for non-randomized studies was used to assess the risk of bias. Meta-analysis was performed if RF data were available in more than 3 studies.RESULTS:
Of 11,629 citations reviewed, 30 met inclusion criteria. All 30 were observational, retrospective studies. In all, 1,770 patients were included, 481 died and 21 underwent HT (63 lost to follow-up); 723 patients reached Fontan completion. We found that systemic ventricular dysfunction (odds ratio [OR] 20.7, confidence interval [CI] 10.0-42.5, I2â¯=â¯0%) and atrioventricular valve regurgitation (AVR) were associated with risk of D-HT (OR 3.7, CI 1.9-6.9, I2â¯=â¯14%). RF associations with D-HT could not be derived for right ventricleâdependent coronary circulation, pulmonary arteriovenous malformations, total anomalous pulmonary venous return, arrhythmias, and pulmonary atresia.CONCLUSIONS:
This systematic review and meta-analysis has identified a high mortality rate in children born with non-HLHS SV heart disease and points to potential under-utilization of HT. Systemic ventricular dysfunction and AVR were identified as RFs for D-HT in this subset of patients SV with TA, PA-IVS, and HX.Palavras-chave
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MEDLINE
Assunto principal:
Anormalidades Múltiplas
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Transplante de Coração
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Atresia Tricúspide
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Atresia Pulmonar
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Síndrome de Heterotaxia
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Coração Univentricular
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article