Decision-making for surgery in the management of patients with univentricular heart

Davies, Ryan R.; Pizarro, Christian

doi:10.3389/fped.2015.00061

Cited by 29 publications

(25 citation statements)

References 219 publications

(301 reference statements)

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“…With a follow-up of almost 6 years, and only 13% lost to follow-up, the level of follow-up of children supported by Mécénat-Chirurgie Cardiaque is in line with that of the French university hospitals and international studies 2 and demonstrates the effectiveness of the networks put in place between Mécénat-Chirurgie Cardiaque and the referents of the countries sending their children to us, despite the geographical distance and the difficulties encountered locally. The care of these children who sometimes require two or three interventions 3 should not be hampered by the fear of insufficient follow-up due to remoteness. Nevertheless, in the children who underwent a total cavo-pulmonary connection, the delay between the first medical intervention in France and the completion of the cavo-pulmonary connection was long (almost 8 years), when the current strategy suggests a delay of 2 years until completion.…”

Section: Discussionmentioning

confidence: 99%

Surgery of single ventricles in humanitarian practice: surgery for which patients?

Gouton¹,

Bical²,

Zoghbi

et al. 2019

Cardiol Young

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Objectives:To analyse the feasibility and effectiveness in humanitarian practice of surgical management of children with single-ventricle heart condition.Methods:Retrospective study of children with a single ventricle, managed by the association Mécénat-Chirurgie Cardiaque since 1996, with long-term follow-up after their return home.Results:Of the 138 children in our cohort, 119 had one or more surgeries (180 procedures): palliative surgery alone (systemic-pulmonary anastomosis or banding), 41; partial cavo-pulmonary connection, 47; total cavo-pulmonary connection (mean age 8.5 years), 31. Operative mortality is 5.5%. After a mean follow-up of 5.6 years, 18 children (13%) were lost to follow-up. Survival at 10 years is 79% in children receiving surgery (palliative only, 72%; partial cavo-pulmonary connection, 77%; total cavo-pulmonary connection, 97%) versus 29% in children with no surgical intervention. The prognosis is better for tricuspid atresia and double-inlet left ventricle (86 and 83% survival at 10 years) than for double-outlet right ventricle or complete atrio-ventricular canal defect (64 and 68% at 5 years).Conclusion:The surgery of the single ventricle in humanitarian medicine allows a very satisfactory survival after one or more surgeries tending towards a total cavo-pulmonary connection as soon as possible.

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Section: Discussionmentioning

confidence: 99%

Surgery of single ventricles in humanitarian practice: surgery for which patients?

Gouton¹,

Bical²,

Zoghbi

et al. 2019

Cardiol Young

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show abstract

“…80 In addition, augmented PBF may decrease the stimulus for the development or actual regression of PAVMs and systemic-to-pulmonary collateralization. 81 This approach is not without disadvantages. Adding additional sources of PBF imposes a persistent volume load on the remodeling ventricle, which may worsen AVVR or ventricular function, particularly in single ventricle patients where the additional blood source is an aortopulmonary shunt.…”

Section: Surgical Methods Of Augmenting Pulmonary Blood Flowmentioning

confidence: 99%

Superior Cavopulmonary Connection: Its Physiology, Limitations, and Anesthetic Implications

Choi

DiNardo

Brown

2020

Semin Cardiothorac Vasc Anesth

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The superior cavopulmonary connection (SCPC) or “bidirectional Glenn” is an integral, intermediate stage in palliation of single ventricle patients to the Fontan procedure. The procedure, normally performed at 3 to 6 months of life, increases effective pulmonary blood flow and reduces the ventricular volume load in patients with single ventricle (parallel circulation) physiology. While the SCPC, with or without additional sources of pulmonary blood flow, cannot be considered a long-term palliation strategy, there are a subset of patients who require SCPC palliation for a longer interval than the typical patient. In this article, we will review the physiology of SCPC, the consequences of prolonged SCPC palliation, and modes of failure. We will also discuss strategies to augment pulmonary blood flow in the presence of an SCPC. The anesthetic considerations in SCPC patients will also be discussed, as these patients may present for noncardiac surgery from infancy to adulthood.

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“…Neonates present a particular challenge as their pulmonary vascular resistance is elevated early in life, requiring a staged approach to control pulmonary blood flow and allow development of the vascular bed (7). Furthermore, infants with low birth weight, prematurity, and coexisting comorbidities add increased complexity and challenges.…”

Section: Hybrid Stage I Palliation In Hlhsmentioning

confidence: 99%

Popular Hybrid Congenital Heart Procedures without Cardiopulmonary Bypass

Gupta

Amin

2017

Front. Surg.

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As surgical and catheter interventions advance, patients with congenital heart disease are now offered alternative treatment options that cater to their individual needs. Furthermore, collaboration between interventional cardiologists and cardiac surgeons have led to the development of hybrid procedures, using the best techniques of each respective field to treat these complex cardiac entities from initial treatment in the pediatric patient to repeat intervention in the adult. We present a review of the increased popularity and trend in hybrid procedures in congenital heart disease without the use of cardiopulmonary bypass.

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Decision-making for surgery in the management of patients with univentricular heart

Cited by 29 publications

References 219 publications

Surgery of single ventricles in humanitarian practice: surgery for which patients?

Surgery of single ventricles in humanitarian practice: surgery for which patients?

Superior Cavopulmonary Connection: Its Physiology, Limitations, and Anesthetic Implications

Popular Hybrid Congenital Heart Procedures without Cardiopulmonary Bypass

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