Pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries
Objective The aims of our study are to describe the incidence, clinical profile, and risk factors for pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries. We hypothesized the following: (1) Pulmonar...
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| creator | Maskatia, Shiraz A., MD Feinstein, Jeffrey A., MD, MPH Newman, Beverley, MD Hanley, Frank L., MD Roth, Stephen J., MD, MPH |
| description | Objective The aims of our study are to describe the incidence, clinical profile, and risk factors for pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries. We hypothesized the following: (1) Pulmonary reperfusion injury is more likely to occur after unifocalization procedures in which a septated circulation is not achieved, (2) pulmonary reperfusion injury is directly related to the severity of stenosis in major aortopulmonary collateral arteries, and (3) pulmonary reperfusion injury leads to longer intubation time and longer hospitalization. Methods Consecutive patients with tetralogy of Fallot/pulmonary atresia/major aortopulmonary collateral arteries who underwent unifocalization procedures over a 5-year period were identified in our institutional database. Chest radiographs before the unifocalization procedure, from postoperative days 0 to 4, and from 2 weeks after the unifocalization procedure or at discharge were evaluated by a pediatric radiologist for localized pulmonary edema. Determination of stenosis severity was based on review of preoperative angiograms. Statistical analyses using multivariate repeated-measures analyses were performed with generalized estimating equations. Results Pulmonary reperfusion injury was present after 42 of 65 (65%) unifocalization procedures. In 36 of 42 cases of reperfusion injury, unilateral injury was present. Risk factors for the development of reperfusion injury included bilateral unifocalization ( P = .01) and degree of stenosis ( P = .03). We did not identify an association between pulmonary reperfusion injury and time to tracheal extubation or hospital discharge. Conclusions Pulmonary reperfusion injury is common after the unifocalization procedure for tetralogy of Fallot/pulmonary atresia/major aortopulmonary collateral arteries. Severity of stenosis and bilateral unifocalization are associated with the development of reperfusion injury. |
| doi_str_mv | 10.1016/j.jtcvs.2011.12.030 |
| format | Article |
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We hypothesized the following: (1) Pulmonary reperfusion injury is more likely to occur after unifocalization procedures in which a septated circulation is not achieved, (2) pulmonary reperfusion injury is directly related to the severity of stenosis in major aortopulmonary collateral arteries, and (3) pulmonary reperfusion injury leads to longer intubation time and longer hospitalization. Methods Consecutive patients with tetralogy of Fallot/pulmonary atresia/major aortopulmonary collateral arteries who underwent unifocalization procedures over a 5-year period were identified in our institutional database. Chest radiographs before the unifocalization procedure, from postoperative days 0 to 4, and from 2 weeks after the unifocalization procedure or at discharge were evaluated by a pediatric radiologist for localized pulmonary edema. Determination of stenosis severity was based on review of preoperative angiograms. Statistical analyses using multivariate repeated-measures analyses were performed with generalized estimating equations. Results Pulmonary reperfusion injury was present after 42 of 65 (65%) unifocalization procedures. In 36 of 42 cases of reperfusion injury, unilateral injury was present. Risk factors for the development of reperfusion injury included bilateral unifocalization ( P = .01) and degree of stenosis ( P = .03). We did not identify an association between pulmonary reperfusion injury and time to tracheal extubation or hospital discharge. Conclusions Pulmonary reperfusion injury is common after the unifocalization procedure for tetralogy of Fallot/pulmonary atresia/major aortopulmonary collateral arteries. Severity of stenosis and bilateral unifocalization are associated with the development of reperfusion injury.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2011.12.030</identifier><identifier>PMID: 22244564</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Abnormalities, Multiple - surgery ; Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Aorta, Thoracic - abnormalities ; Aorta, Thoracic - diagnostic imaging ; Biological and medical sciences ; Biomarkers - blood ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Cardiovascular Surgical Procedures - methods ; Child ; Child, Preschool ; Collateral Circulation ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Female ; Heart ; Humans ; Infant ; Male ; Medical sciences ; Pneumology ; Pulmonary Artery - abnormalities ; Pulmonary Artery - diagnostic imaging ; Pulmonary Atresia - complications ; Pulmonary Atresia - diagnostic imaging ; Pulmonary Atresia - surgery ; Radiography, Thoracic ; Reperfusion Injury - diagnostic imaging ; Reperfusion Injury - etiology ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Statistics, Nonparametric ; Tetralogy of Fallot - complications ; Tetralogy of Fallot - diagnostic imaging ; Tetralogy of Fallot - surgery</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2012-07, Vol.144 (1), p.184-189</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2012 The American Association for Thoracic Surgery</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-f0d4854ff88a4752f814fcad5086a7497c916921cb9c9e08fa78724fa33f3af83</citedby><cites>FETCH-LOGICAL-c489t-f0d4854ff88a4752f814fcad5086a7497c916921cb9c9e08fa78724fa33f3af83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jtcvs.2011.12.030$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26017086$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22244564$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maskatia, Shiraz A., MD</creatorcontrib><creatorcontrib>Feinstein, Jeffrey A., MD, MPH</creatorcontrib><creatorcontrib>Newman, Beverley, MD</creatorcontrib><creatorcontrib>Hanley, Frank L., MD</creatorcontrib><creatorcontrib>Roth, Stephen J., MD, MPH</creatorcontrib><title>Pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective The aims of our study are to describe the incidence, clinical profile, and risk factors for pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries. We hypothesized the following: (1) Pulmonary reperfusion injury is more likely to occur after unifocalization procedures in which a septated circulation is not achieved, (2) pulmonary reperfusion injury is directly related to the severity of stenosis in major aortopulmonary collateral arteries, and (3) pulmonary reperfusion injury leads to longer intubation time and longer hospitalization. Methods Consecutive patients with tetralogy of Fallot/pulmonary atresia/major aortopulmonary collateral arteries who underwent unifocalization procedures over a 5-year period were identified in our institutional database. Chest radiographs before the unifocalization procedure, from postoperative days 0 to 4, and from 2 weeks after the unifocalization procedure or at discharge were evaluated by a pediatric radiologist for localized pulmonary edema. Determination of stenosis severity was based on review of preoperative angiograms. Statistical analyses using multivariate repeated-measures analyses were performed with generalized estimating equations. Results Pulmonary reperfusion injury was present after 42 of 65 (65%) unifocalization procedures. In 36 of 42 cases of reperfusion injury, unilateral injury was present. Risk factors for the development of reperfusion injury included bilateral unifocalization ( P = .01) and degree of stenosis ( P = .03). We did not identify an association between pulmonary reperfusion injury and time to tracheal extubation or hospital discharge. Conclusions Pulmonary reperfusion injury is common after the unifocalization procedure for tetralogy of Fallot/pulmonary atresia/major aortopulmonary collateral arteries. Severity of stenosis and bilateral unifocalization are associated with the development of reperfusion injury.</description><subject>Abnormalities, Multiple - surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Aorta, Thoracic - abnormalities</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cardiology. Vascular system</subject><subject>Cardiothoracic Surgery</subject><subject>Cardiovascular Surgical Procedures - methods</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Collateral Circulation</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Pneumology</subject><subject>Pulmonary Artery - abnormalities</subject><subject>Pulmonary Artery - diagnostic imaging</subject><subject>Pulmonary Atresia - complications</subject><subject>Pulmonary Atresia - diagnostic imaging</subject><subject>Pulmonary Atresia - surgery</subject><subject>Radiography, Thoracic</subject><subject>Reperfusion Injury - diagnostic imaging</subject><subject>Reperfusion Injury - etiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Statistics, Nonparametric</subject><subject>Tetralogy of Fallot - complications</subject><subject>Tetralogy of Fallot - diagnostic imaging</subject><subject>Tetralogy of Fallot - surgery</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFktGK1TAQhoso7nH1CQTJjeDFtiZp2qYXCrK4KiwoqOBdmE0nmtrTHJN04fgmvq1Tz3EXvPEqEL5_5p_5pygeC14JLtrnYzVme50qyYWohKx4ze8UG8H7rmx18-VuseFcyrKRsj4pHqQ0cs47Lvr7xYmUUqmmVZvi14dl2oYZ4p5F3GF0S_JhZn4eF_oClzGy_A3ZMnsXLEz-J-QV2MVgcVgiMheIwBxhCl_3LDh2AdMU8hnb3VSGHDF5OGMwD2wLIykgxBxuCRumCagXTAwivR7Tw-Kegynho-N7Wny-eP3p_G15-f7Nu_NXl6VVus-l44PSjXJOa1BdI50WylkYGq5b6FTf2V60vRT2qrc9cu2g051UDura1eB0fVo8O9SlkX4smLLZ-mSR_MwYlmQEl0I2uul7QusDamNIKaIzu-i35J8gs2ZiRvMnE7NmYoQ0lAmpnhwbLFdbHG40f0Mg4OkRgEQrdhFm69Mt13LR0TTEvThwSOu49hhNsh5nysFHtNkMwf_HyMt_9Hbys6eW33GPaQxLnGnTRphEAvNxPZ_1egRVVIoM_AZYNcTF</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Maskatia, Shiraz A., MD</creator><creator>Feinstein, Jeffrey A., MD, MPH</creator><creator>Newman, Beverley, MD</creator><creator>Hanley, Frank L., MD</creator><creator>Roth, Stephen J., MD, MPH</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries</title><author>Maskatia, Shiraz A., MD ; Feinstein, Jeffrey A., MD, MPH ; Newman, Beverley, MD ; Hanley, Frank L., MD ; Roth, Stephen J., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-f0d4854ff88a4752f814fcad5086a7497c916921cb9c9e08fa78724fa33f3af83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abnormalities, Multiple - surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Aorta, Thoracic - abnormalities</topic><topic>Aorta, Thoracic - diagnostic imaging</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Cardiovascular Surgical Procedures - methods</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Collateral Circulation</topic><topic>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Pneumology</topic><topic>Pulmonary Artery - abnormalities</topic><topic>Pulmonary Artery - diagnostic imaging</topic><topic>Pulmonary Atresia - complications</topic><topic>Pulmonary Atresia - diagnostic imaging</topic><topic>Pulmonary Atresia - surgery</topic><topic>Radiography, Thoracic</topic><topic>Reperfusion Injury - diagnostic imaging</topic><topic>Reperfusion Injury - etiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Statistics, Nonparametric</topic><topic>Tetralogy of Fallot - complications</topic><topic>Tetralogy of Fallot - diagnostic imaging</topic><topic>Tetralogy of Fallot - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maskatia, Shiraz A., MD</creatorcontrib><creatorcontrib>Feinstein, Jeffrey A., MD, MPH</creatorcontrib><creatorcontrib>Newman, Beverley, MD</creatorcontrib><creatorcontrib>Hanley, Frank L., MD</creatorcontrib><creatorcontrib>Roth, Stephen J., MD, MPH</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maskatia, Shiraz A., MD</au><au>Feinstein, Jeffrey A., MD, MPH</au><au>Newman, Beverley, MD</au><au>Hanley, Frank L., MD</au><au>Roth, Stephen J., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>144</volume><issue>1</issue><spage>184</spage><epage>189</epage><pages>184-189</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Objective The aims of our study are to describe the incidence, clinical profile, and risk factors for pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries. We hypothesized the following: (1) Pulmonary reperfusion injury is more likely to occur after unifocalization procedures in which a septated circulation is not achieved, (2) pulmonary reperfusion injury is directly related to the severity of stenosis in major aortopulmonary collateral arteries, and (3) pulmonary reperfusion injury leads to longer intubation time and longer hospitalization. Methods Consecutive patients with tetralogy of Fallot/pulmonary atresia/major aortopulmonary collateral arteries who underwent unifocalization procedures over a 5-year period were identified in our institutional database. Chest radiographs before the unifocalization procedure, from postoperative days 0 to 4, and from 2 weeks after the unifocalization procedure or at discharge were evaluated by a pediatric radiologist for localized pulmonary edema. Determination of stenosis severity was based on review of preoperative angiograms. Statistical analyses using multivariate repeated-measures analyses were performed with generalized estimating equations. Results Pulmonary reperfusion injury was present after 42 of 65 (65%) unifocalization procedures. In 36 of 42 cases of reperfusion injury, unilateral injury was present. Risk factors for the development of reperfusion injury included bilateral unifocalization ( P = .01) and degree of stenosis ( P = .03). We did not identify an association between pulmonary reperfusion injury and time to tracheal extubation or hospital discharge. Conclusions Pulmonary reperfusion injury is common after the unifocalization procedure for tetralogy of Fallot/pulmonary atresia/major aortopulmonary collateral arteries. Severity of stenosis and bilateral unifocalization are associated with the development of reperfusion injury.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22244564</pmid><doi>10.1016/j.jtcvs.2011.12.030</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abnormalities, Multiple - surgery Adolescent Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Aorta, Thoracic - abnormalities Aorta, Thoracic - diagnostic imaging Biological and medical sciences Biomarkers - blood Cardiology. Vascular system Cardiothoracic Surgery Cardiovascular Surgical Procedures - methods Child Child, Preschool Collateral Circulation Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Female Heart Humans Infant Male Medical sciences Pneumology Pulmonary Artery - abnormalities Pulmonary Artery - diagnostic imaging Pulmonary Atresia - complications Pulmonary Atresia - diagnostic imaging Pulmonary Atresia - surgery Radiography, Thoracic Reperfusion Injury - diagnostic imaging Reperfusion Injury - etiology Retrospective Studies Risk Factors Severity of Illness Index Statistics, Nonparametric Tetralogy of Fallot - complications Tetralogy of Fallot - diagnostic imaging Tetralogy of Fallot - surgery |
| title | Pulmonary reperfusion injury after the unifocalization procedure for tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries |
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