Details

Autor(en) / Beteiligte

• Xu, Yao-qiang
• Liu, Ying-long
• Lü, Xiao-dong
• Li, Yong-qing
• Yu, Cun-tao

Titel

Bilateral bidirectional superior cavopulmonary shunt is more beneficial in medium and long term clinical outcomes than unilateral shunt

Ist Teil von

• Chinese medical journal, 2009-01, Vol.122 (2), p.129-135

Ort / Verlag

China: Pediatric Cardiac Center, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China%Pediatric Cardiac Center,Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China

Erscheinungsjahr

2009

Quelle

MEDLINE

Beschreibungen/Notizen

• Background The present study was aimed to compare the effects of bilateral and unilateral bidirectional superior cavopulmonary shunt （b-BDG and u-BDG） on pulmonary artery growth and clinical outcomes. Methods The 51 subjects enrolled in this study were divided into two groups： those receiving b-BDG （n=21） and those receiving u-BDG （n=30）. Clinical records were reviewed retrospectively at a mean of 43.3 months after BDG procedures. Chi square and t-tests were performed to analyze the data. Results Left and right pulmonary artery diameters increased 27%-37% in both groups. The pulmonary artery index increased 37.2% after b-BDG and 27.0% after u-BDG, b-BDG patients experienced a significant decrease in mean hemoglobin concentration and hematocrit value, and a correlated change in postoperative diameter of left pulmonary artery （LPA） and pulmonary artery index （y=0.2719, x=-1.8278; R=0.564, P=-0.008）. The change ratio of hemoglobin and postoperative LPA were also correlated in b-BDG patients （y= -0.0522x ＋ 0.3539; R=-0.479, P=-0.028）. Only one b-BDG patient versus twelve u-BDG patients needed total cavopulmonary connections 31.8 months after BDG surgery （P=-0.0074）. Moreover, only one （4.8%） b-BDG patient but eight u-BDG patients （26.7%） developed pulmonary arteriovenous malformations. Conclusions b-BDG increases bilateral pulmonary blood flow and promotes growth of bilateral pulmonary arteries, with preferable physiological outcomes to u-BDG. Results may imply that subsequent Fontan repair may not always be needed. Chin Med J 2009; 122（2）： 129-135