Catheter interventions in the staged management of hypoplastic left heart syndrome.
Cardiol Young
; 24(2): 212-9, 2014 Apr.
Article
in En
| MEDLINE
| ID: mdl-23391024
ABSTRACT
AIM:
To analyse the current practice and contribution of catheter interventions in the staged management of patients with hypoplastic left heart syndrome.METHODS:
This study is a retrospective case note review of 527 patients undergoing staged Norwood/Fontan palliation at a single centre between 1993 and 2010. Indications and type of catheter interventions were reviewed over a median follow-up period of 7.5 years.RESULTS:
A staged Norwood/Fontan palliation for hypoplastic left heart syndrome was performed in 527 patients. The 30-day survival rate after individual stages was 76.5% at Stage I, 96.3% at Stage II, and 99.4% at Stage III. A total of 348 interventions were performed in 189 out of 527 patients. Freedom from catheter intervention in survivors was 58.2% before Stage II and 46.7% before Stage III. Kaplan-Meier freedom from intervention post Fontan completion was 55% at 10.8 years of follow-up. Post-stage I interventions were mostly directed to relieve aortic arch obstruction--84 balloon angioplasties--and augment pulmonary blood flow--15 right ventricle-to-pulmonary conduit interventions; post-Stage II interventions centred on augmenting size of the left pulmonary artery--73 procedures and abolishing systemic venous collaterals--32 procedures. After Stage III, the focus was on manipulating the size of the fenestration--42 interventions--and the left pulmonary artery -31 procedures.CONCLUSION:
Interventional cardiac catheterisation constitutes an integral part in the staged palliative management of patients with hypoplastic left heart syndrome. Over one-third (37%) of patients undergoing staged palliation required catheter intervention over the follow-up period.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aortic Coarctation
/
Pulmonary Artery
/
Cardiac Catheterization
/
Hypoplastic Left Heart Syndrome
/
Fontan Procedure
/
Atrial Septum
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
Cardiol Young
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
PEDIATRIA
Year:
2014
Document type:
Article
Affiliation country:
Reino Unido