Original ArticleCardiovascularInterim Mortality in Pulmonary Atresia With Intact Ventricular Septum
Section snippets
Patients and Methods
Between January 1991 and December 2001, at two centers, a total of 35 infants 60 days of age or younger underwent placement of systemic-to-pulmonary artery shunts as a source of pulmonary blood flow in patients undergoing palliative management of PAIVS. The period for the study was selected to allow evaluation of at least midterm outcome in all patients. Patients with PAIVS who had pulmonary valvotomy alone (no shunt), either in the cardiac catheterization laboratory or in the operating room,
Results
There were 22 patients with severe RV hypoplasia (61%), and 14 with two ventricles. One of the patients with two ventricles ultimately underwent a one-and-one-half ventricle repair. Twenty-two patients (including 6 without severe RV hypoplasia) had identifiable sinusoids or right-ventricle-to-coronary-artery fistulas. Only 1 patient was identified with RV-dependent coronary circulation. Two patients had Ebstein's malformation of the tricuspid valve. Four infants were premature (<35 weeks), 2
Comment
Neonatal cardiac surgery has become almost commonplace throughout the developed world, and excellent early results of both reparative and palliative operations are now essentially expected. Hospital mortality rates are in the single digits for repair or palliation of most cardiac defects, and 30-day survival even for infants with the most complex defects such as HLHS is 70% to 90% in many centers [1, 3, 5]. As a result, our attention has recently been redirected to improving intermediate-term
References (16)
- et al.
Outcomes after the Norwood operation in neonates with critical aortic stenosis or aortic valve atresia
J Thorac Cardiovasc Surg
(2003) - et al.
Unexpected death after reconstructive surgery for hypoplastic left heart syndrome
Ann Thorac Surg
(2001) - et al.
Outcome in infants with pulmonary atresia, intact ventricular septum, and right ventricle-dependent coronary circulation
Am J Cardiol
(2000) - et al.
Echocardiographic predictors of coronary artery pathology in pulmonary atresia with intact ventricular septum
Am J Cardiol
(2000) - et al.
Right ventricle-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome
J Thorac Cardiovasc Surg
(2003) - et al.
Home surveillance program prevents interstage mortality following the Norwood procedure
J Thorac Cardiovasc Surg
(2003) - et al.
Hypoplastic left heart syndrome. Outcome after initial reconstruction and before modified Fontan procedure
Circulation
(1990) - et al.
Interim mortality in infants with systemic-to-pulmonary artery shunts
Ann Thorac Surg
(2003)
Cited by (40)
Procedural Outcomes of Pulmonary Atresia With Intact Ventricular Septum in Neonates: A Multicenter Study
2023, Annals of Thoracic SurgeryPulmonary atresia/intact ventricular septum: Influence of coronary anatomy on single-ventricle outcome
2014, Annals of Thoracic SurgeryOutcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: Analysis of shunt type, size, and surgical approach
2014, Journal of Thoracic and Cardiovascular SurgeryOutcomes after listing for primary transplantation for infants with unoperated-on non-hypoplastic left heart syndrome congenital heart disease: A multi-institutional study
2011, Journal of Heart and Lung TransplantationPulmonary stenosis and atresia with intact ventricular septum
2011, Archives de Pediatrie