Surgery of single ventricles in humanitarian practice: surgery for which patients?

To analyse the feasibility and effectiveness in humanitarian practice of surgical management of children with single-ventricle heart condition. Retrospective study of children with a single ventricle, managed by the association Mécénat-Chirurgie Cardiaque since 1996, with long-term follow-up after t...

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Veröffentlicht in:Cardiology in the young 2019-05, Vol.29 (5), p.583-588
Hauptverfasser: Gouton, Marielle, Bical, Olivier Michel, Zoghbi, Joy, Roussin, Régine, Lucet, Vincent, Leca, Francine
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container_issue 5
container_start_page 583
container_title Cardiology in the young
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creator Gouton, Marielle
Bical, Olivier Michel
Zoghbi, Joy
Roussin, Régine
Lucet, Vincent
Leca, Francine
description To analyse the feasibility and effectiveness in humanitarian practice of surgical management of children with single-ventricle heart condition. Retrospective study of children with a single ventricle, managed by the association Mécénat-Chirurgie Cardiaque since 1996, with long-term follow-up after their return home. Of the 138 children in our cohort, 119 had one or more surgeries (180 procedures): palliative surgery alone (systemic-pulmonary anastomosis or banding), 41; partial cavo-pulmonary connection, 47; total cavo-pulmonary connection (mean age 8.5 years), 31. Operative mortality is 5.5%. After a mean follow-up of 5.6 years, 18 children (13%) were lost to follow-up. Survival at 10 years is 79% in children receiving surgery (palliative only, 72%; partial cavo-pulmonary connection, 77%; total cavo-pulmonary connection, 97%) versus 29% in children with no surgical intervention. The prognosis is better for tricuspid atresia and double-inlet left ventricle (86 and 83% survival at 10 years) than for double-outlet right ventricle or complete atrio-ventricular canal defect (64 and 68% at 5 years). The surgery of the single ventricle in humanitarian medicine allows a very satisfactory survival after one or more surgeries tending towards a total cavo-pulmonary connection as soon as possible.
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Retrospective study of children with a single ventricle, managed by the association Mécénat-Chirurgie Cardiaque since 1996, with long-term follow-up after their return home. Of the 138 children in our cohort, 119 had one or more surgeries (180 procedures): palliative surgery alone (systemic-pulmonary anastomosis or banding), 41; partial cavo-pulmonary connection, 47; total cavo-pulmonary connection (mean age 8.5 years), 31. Operative mortality is 5.5%. After a mean follow-up of 5.6 years, 18 children (13%) were lost to follow-up. Survival at 10 years is 79% in children receiving surgery (palliative only, 72%; partial cavo-pulmonary connection, 77%; total cavo-pulmonary connection, 97%) versus 29% in children with no surgical intervention. The prognosis is better for tricuspid atresia and double-inlet left ventricle (86 and 83% survival at 10 years) than for double-outlet right ventricle or complete atrio-ventricular canal defect (64 and 68% at 5 years). The surgery of the single ventricle in humanitarian medicine allows a very satisfactory survival after one or more surgeries tending towards a total cavo-pulmonary connection as soon as possible.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>31046854</pmid><doi>10.1017/S1047951119000192</doi><tpages>6</tpages></addata></record>
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subjects Anastomosis
Cardiology
Child
Child, Preschool
Children
Children & youth
Congenital diseases
Developing Countries
Female
Follow-Up Studies
Fontan Procedure - methods
Fontan Procedure - statistics & numerical data
France
Heart
Heart Defects, Congenital - mortality
Heart Defects, Congenital - surgery
Heart surgery
Heart Ventricles - abnormalities
Heart Ventricles - surgery
Hemodynamics
Humans
LDCs
Male
Medical prognosis
Mortality
Original Article
Palliative Care - methods
Pulmonary arteries
Relief Work
Retrospective Studies
Risk Factors
Statistical analysis
Surgery
Survival
Survival Rate - trends
Treatment Outcome
Tricuspid atresia
Veins & arteries
Ventricle
title Surgery of single ventricles in humanitarian practice: surgery for which patients?
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