Impact of age at bidirectional cavopulmonary anastomosis on haemodynamics after Fontan operation.
Impact of age at bidirectional cavopulmonary anastomosis on haemodynamics after Fontan operation.
复制标题
双向腔肺吻合术年龄对 Fontan 术后血流动力学的影响。
DOI：
10.1017/s1047951118001543
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发表时间：
2018
期刊：
影响因子：
1
通讯作者：
Hideaki Kado.
中科院分区：
文献类型：
--
作者：
Shuichi Shiraishi;Toshide Nakano;Shinichiro Oda;Hideaki Kado.
BackgroundsThe aim of this study was to assess the impact of age at bidirectional cavernous anastomosis on血流动力学after total cavernous connection.MethodsWe进行了回顾性分析，100例连续患者谁进行了全cavernous连接从2010年至2014年。所有患者既往均接受过双向腔静脉吻合术。根据双向腔静脉吻合术时的年龄将这些患者分为两组：年轻组，<6个月（n=33），和老年组，>6个月（n=67）。全腔静脉连接后，年轻组的胸管时间较长（10.1±6.6 vs 6.7±4.5天; p=0.009）。全腔静脉连接后6个月的导管检查显示，年轻组的肺动脉压较高（11.5±1.9 vs 10.4±2.1 mmHg; p=0.017），Nakata指数较低（219±79 vs 256±70 mm 2/m2; p=0.024）。在非发育不良性左心综合征患者中，两组患者术后血流动力学无差异，但年轻组全腔静脉连接后的胸腔引流量较大（109±95 vs 55±40 ml/kg; p=0.044）。全腔静脉吻合术后早期患者胸管留置时间较长，肺动脉较小，肺动脉压较高，尤其是左心发育不良综合征患者。
BackgroundsThe aim of this study was to assess the impact of age at bidirectional cavopulmonary anastomosis on haemodynamics after total cavopulmonary connection.MethodsWe conducted a retrospective analysis of 100 consecutive patients who underwent total cavopulmonary connection from 2010 to 2014. All patients had previously undergone bidirectional cavopulmonary anastomosis. These patients were classified into two groups according to age at bidirectional cavopulmonary anastomosis: younger group, <6 months (n=33), and older group, >6 months (n=67).ResultsThe proportion of hypoplastic left heart syndrome was higher in the younger group (48 versus 4%). After total cavopulmonary connection, the chest tube period was longer in the younger group (10.1±6.6 versus 6.7±4.5 days; p=0.009). Catheterisation 6 months after total cavopulmonary connection revealed that pulmonary artery pressure was higher (11.5±1.9 versus 10.4±2.1 mmHg; p=0.017) and Nakata index was lower (219±79 versus 256±70 mm2/m2; p=0.024) in the younger group. In patients with a non-hypoplastic left heart syndrome, there was no difference in post-operative haemodynamics between two groups, but the total amount of chest drainage after total cavopulmonary connection was larger in the younger group (109±95 versus 55±40 ml/kg; p=0.044).ConclusionsEarly bidirectional cavopulmonary anastomosis did not affect the outcome of total cavopulmonary connection. Longer chest tube period, smaller pulmonary artery, and higher pulmonary artery pressure after total cavopulmonary connection were recognised in early bidirectional cavopulmonary anastomosis patients, especially in hypoplastic left heart syndrome.