https://scholars.lib.ntu.edu.tw/handle/123456789/475394
標題: | Risk Factors for Mortality After the Norwood Procedure Using Right Ventricle to Pulmonary Artery Shunt | 作者: | Sano S. SHU-CHIEN HUANG Kasahara S. Yoshizumi K. Kotani Y. Ishino K. |
公開日期: | 2009 | 卷: | 87 | 期: | 1 | 起(迄)頁: | 178-186 | 來源出版物: | Annals of Thoracic Surgery | 摘要: | Background: The purpose of this study was to describe the experience with staged surgical reconstruction of the hypoplastic left heart syndrome (HLHS) with a right ventricle to pulmonary artery conduit and to identify the risk factors that influence late outcome. Methods: Between February 1998 and June 2007, 62 patients with HLHS underwent a Norwood procedure by using right ventricle to pulmonary artery conduit (median age, 9 days [range, 1 to 57]; median body weight 2.7 kg [range, 1.6 to 3.9 kg]). The subsequent 47 patients underwent a bidirectional Glenn procedure (stage 2). Thirty-two patients underwent a modified Fontan procedure (stage 3). Follow-up was complete (median, 32 months; range, 1 to 101). Results: Hospital mortality after the Norwood procedure was 8% (5 of 62 patients). Between stages, 9 patients died, 3 before stage 2 and 6 before stage 3. There was 1 late death after stage 3. Overall survival was 76% (47 of 62). The estimated 1-year and and 5-year survival rates were 80% and 73%, respectively. Using the any-mortality as the endpoint, prematurity (gestational age <37 weeks), body weight less than 2.5 kg at stage 1 operation, and tricuspid regurgitation 2+ or more were associated with mortality. Using Cox regression analysis, body weight less than 2.5 kg and tricuspid regurgitation 2+ or more were two independent factors associated with midterm survival. Conclusions: From 9 years of experience, despite good early survival after Norwood stage 1 palliation, low body weight and tricuspid valve regurgitation were still associated with worse outcome. More efforts should be made to improve the late results for patients with hypoplastic left heart syndrome. ? 2009 The Society of Thoracic Surgeons. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-57649227407&doi=10.1016%2fj.athoracsur.2008.08.027&partnerID=40&md5=85541b8eb562949445f2880ec452a8f6 https://scholars.lib.ntu.edu.tw/handle/123456789/475394 |
ISSN: | 0003-4975 | DOI: | 10.1016/j.athoracsur.2008.08.027 | SDG/關鍵字: | adolescent; adult; artery bypass; article; child; controlled study; female; Glenn shunt; heart right ventricle; human; hypoplastic left heart syndrome; infant; major clinical study; male; mortality; Norwood procedure; priority journal; pulmonary artery; risk factor; survival; Cardiopulmonary Bypass; Cardiovascular Surgical Procedures; Cause of Death; Cohort Studies; Education, Medical, Continuing; Female; Follow-Up Studies; Fontan Procedure; Heart Bypass, Right; Heart Ventricles; Hospital Mortality; Humans; Hypoplastic Left Heart Syndrome; Infant; Infant, Newborn; Kaplan-Meiers Estimate; Male; Multivariate Analysis; Palliative Care; Postoperative Complications; Probability; Proportional Hazards Models; Pulmonary Artery; Reoperation; Retrospective Studies; Risk Assessment; Sensitivity and Specificity; Survival Rate; Time Factors |
顯示於: | 醫學系 |
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