Heterotaxy Adverse Long-Term Outcomes After Fontan Completion
Heterotaxy Adverse Long-Term Outcomes After Fontan Completion
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DOI：
10.1016/j.athoracsur.2019.11.015
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发表时间：
2020-08-01
影响因子：
4.6
通讯作者：
Winlaw, David S.
中科院分区：
文献类型：
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作者：
Marathe, Supreet P.;Zannino, Diana;Winlaw, David S.
背景异位被认为是Fontan手术后不良结局的危险因素。然而，缺乏支持这一观点的长期数据。本研究的目的是确定在Fontan完成后，异位症患者出院后的长期结果，并将这些结果与当代非异位症队列进行比较。分析了两国Fontan登记研究（n = 1540），以确定有异位的患者，并将其与无异位的患者进行比较。主要复合终点为Fontan衰竭，包括死亡、心脏移植、Fontan拆除或转换、蛋白丢失性肠病、可塑性支气管炎或纽约心脏协会功能III或IV级。共确定了109例异位患者，并将其与Fontan完成后的1431例非异位患者进行了比较。未校正的15年无Fontan失败率无差异（异位，78% vs非异位，85%; P = 0.2）。异位组患者Fontan术后心律失常的累积发生率显著较高（P
Background. Heterotaxy is considered a risk factor for poor outcomes after the Fontan operation. However, longterm data to support this notion are lacking. The aims of this study were to ascertain the long-term outcomes of patients with heterotaxy after hospital discharge after Fontan completion and to compare these outcomes with those of a contemporary nonheterotaxy cohort.Methods. A binational Fontan registry (n = 1540) was analyzed to identify patients with heterotaxy and compare them with patients without heterotaxy. The primary composite end point was Fontan failure, encompassing death, heart transplantation, Fontan take-down or conversion, protein-losing enteropathy, plastic bronchitis, or New York Heart Association functional class III or IV.Results. A total of 109 patients with heterotaxy were identified and they were compared with 1431 nonheterotaxy patients after Fontan completion. There was no difference in unadjusted 15-year freedom from Fontan failure (heterotaxy, 78% vs nonheterotaxy, 85%; P = .2). Patients in the heterotaxy group had a significantly higher cumulative incidence of post- Fontan arrhythmias (P