Platelet count and abdominal dynamic CT are useful in predicting and screening for gastroesophageal varices after Fontan surgery.
Platelet count and abdominal dynamic CT are useful in predicting and screening for gastroesophageal varices after Fontan surgery.
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DOI：
10.1371/journal.pone.0257441
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Tokuhara D
中科院分区：
文献类型：
--
作者：
Isoura Y;Yamamoto A;Cho Y;Ehara E;Jogo A;Suzuki T;Amano-Teranishi Y;Kioka K;Hamazaki T;Murakami Y;Tokuhara D
因复杂心脏异常而接受 Fontan 手术的患者容易出现肝脏和胃肠道并发症。特别是，可能会发生胃食管静脉曲张（GEV），但其患病率尚不清楚。我们的目的是阐明这些患者中 GEV 的发生以及 GEV 的预测参数。该研究纳入了 27 名接受 Fontan 手术并接受腹部动态计算机断层扫描 (CT) 检查以进行常规随访的患者（中位年龄 14.8 岁；中位手术时间 12.9 岁）。包括 GEV 和肠外并发症在内的放射学结果由经验丰富的放射科医生以盲法进行回顾性评估。对血液生化和人口参数与 GEV 存在之间的关系进行了统计分析。动态 CT 显示胃静脉曲张（n = 3，11.1%）、食管静脉曲张（n = 1，3.7%）和胃肾分流（n = 5，18.5%）。所有胃静脉曲张患者均接受胃肾分流术。所有胃静脉曲张均经内镜证实为孤立性扩大，有预防性介入治疗指征。血小板计数低于 119 × 109 /L 被确定为 GEV 的预测因子（受试者工作曲线下面积，0.946；敏感性，100%；特异性，87%）。 GEV 是接受 Fontan 手术的患者不应忽视的重要并发症。血小板计数低于 119 × 109 /L 可能有助于通过使用腹部动态 CT 识别这些患者的 GEV 及其引流侧支静脉来提示患者筛查。
Patients who undergo Fontan surgery for complex cardiac anomalies are prone to developing liver and gastrointestinal complications. In particular, gastroesophageal varices (GEVs) can occur, but their prevalence is unknown. We aimed to elucidate the occurrence of GEVs and the predicting parameters of GEVs in these patients. Twenty-seven patients (median age, 14.8 years; median time since surgery, 12.9 years) who had undergone the Fontan surgery and were examined by abdominal dynamic computed tomography (CT) for the routine follow-up were included in the study. Radiological findings including GEVs and extraintestinal complications were retrospectively evaluated by experienced radiologists in a blinded manner. Relationships between blood-biochemical and demographic parameters and the presence of GEVs were statistically analyzed. Dynamic CT revealed gastric varices (n = 3, 11.1%), esophageal varices (n = 1, 3.7%), and gastrorenal shunts (n = 5, 18.5%). All patients with gastric varices had gastrorenal shunts. All gastric varices were endoscopically confirmed as being isolated and enlarged, with indications for preventive interventional therapy. A platelet count lower than 119 × 109 /L was identified as a predictor of GEV (area under the receiver operating curve, 0.946; sensitivity, 100%; and specificity, 87%). GEVs are important complications that should not be ignored in patients who have undergone a Fontan procedure. Platelet counts lower than 119 × 109 /L may help to prompt patient screening by using abdominal dynamic CT to identify GEVs and their draining collateral veins in these patients.
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影响因子：
1.4
作者：
Nandwana, Sadhna B.;Olaiya, Babatunde;Mittal, Pardeep
通讯作者：
Mittal, Pardeep
DOI：
10.1046/j.1440-1746.2002.02855.x
发表时间：
2002-10-01
影响因子：
4.1
作者：
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DOI：
10.1016/s0022-5223(96)70051-x
发表时间：
1996-09-01
影响因子：
6
作者：
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通讯作者：
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影响因子：
4.6
作者：
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