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Contemporary Outcomes After Pulmonary Artery Banding in Complete Atrioventricular Septal Defect.
Kim, Mi Jin; Cha, Seulgi; Baek, Jae Suk; Yu, Jeong Jin; Kim, Dong-Hee; Choi, Eun Seok; Kwon, Bo Sang; Yun, Tae-Jin; Park, Chun Soo.
Afiliação
  • Kim MJ; Division of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Cha S; Division of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Baek JS; Division of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Yu JJ; Division of Pediatric Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Kim DH; Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Choi ES; Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Kwon BS; Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Yun TJ; Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Park CS; Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: chunsoo@amc.seoul.kr.
Ann Thorac Surg ; 114(6): 2356-2362, 2022 12.
Article em En | MEDLINE | ID: mdl-35405104
BACKGROUND: This study investigated the clinical outcomes and the effect of band tightness on outcome after pulmonary artery banding (PAB) in patients with complete atrioventricular septal defect (AVSD). METHODS: From 2000 through 2019, among 133 patients with isolated complete AVSD pursuing biventricular repair, 34 patients (25.6%) who underwent PAB were included in this study. Factors associated with adverse outcome, which was defined as prolonged stay in the intensive care unit (>10 days), were analyzed using a multiple logistic regression model. Receiver operating characteristic analysis was performed to identify a threshold band tightness for adverse outcome. RESULTS: The median age and weight were 43 days and 3.6 kg, respectively. There were 4 early deaths. The median intensive care unit stay was 8 days. Twenty-eight patients (28/34; 82.4%) underwent definitive repair 10 months (interquartile range, 7-12 months) after PAB. In multivariable analysis, indexed band diameter was identified as a factor associated with adverse outcome (odds ratio, 1.60; 95% CI, 1.03-2.48; P = .035). Receiver operating characteristic analysis indicated 22.2 mm/m2 of indexed PAB diameter measured at discharge as a threshold band tightness for adverse outcome (area under curve, 0.871; P < .001). The level of B-type natriuretic peptide similarly decreased after PAB regardless of band tightness, although the probability of worsening in atrioventricular valve regurgitation was significantly decreased in patients with a tighter band (P = .027). CONCLUSIONS: PAB is a viable option for early-presenting patients with complete AVSD. Tighter PAB might be beneficial for early postoperative outcomes and preventing progression of atrioventricular valve regurgitation in complete AVSD.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artéria Pulmonar / Defeitos dos Septos Cardíacos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Infant Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artéria Pulmonar / Defeitos dos Septos Cardíacos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Infant Idioma: En Ano de publicação: 2022 Tipo de documento: Article