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 |
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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. |
doi_str_mv | 10.1017/S1047951119000192 |
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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.</description><identifier>ISSN: 1047-9511</identifier><identifier>EISSN: 1467-1107</identifier><identifier>DOI: 10.1017/S1047951119000192</identifier><identifier>PMID: 31046854</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>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</subject><ispartof>Cardiology in the young, 2019-05, Vol.29 (5), p.583-588</ispartof><rights>Cambridge University Press 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-41e5fbdd3e902688e259912a7e42f6fd8e0c6dcc7975497e2ab0f7f863eb8b583</citedby><cites>FETCH-LOGICAL-c373t-41e5fbdd3e902688e259912a7e42f6fd8e0c6dcc7975497e2ab0f7f863eb8b583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S1047951119000192/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,780,784,27923,27924,55627</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31046854$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gouton, Marielle</creatorcontrib><creatorcontrib>Bical, Olivier Michel</creatorcontrib><creatorcontrib>Zoghbi, Joy</creatorcontrib><creatorcontrib>Roussin, Régine</creatorcontrib><creatorcontrib>Lucet, Vincent</creatorcontrib><creatorcontrib>Leca, Francine</creatorcontrib><title>Surgery of single ventricles in humanitarian practice: surgery for which patients?</title><title>Cardiology in the young</title><addtitle>Cardiol Young</addtitle><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.</description><subject>Anastomosis</subject><subject>Cardiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Children & youth</subject><subject>Congenital diseases</subject><subject>Developing Countries</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fontan Procedure - methods</subject><subject>Fontan Procedure - statistics & numerical data</subject><subject>France</subject><subject>Heart</subject><subject>Heart Defects, Congenital - mortality</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Heart surgery</subject><subject>Heart Ventricles - abnormalities</subject><subject>Heart Ventricles - surgery</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>LDCs</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Original Article</subject><subject>Palliative Care - methods</subject><subject>Pulmonary arteries</subject><subject>Relief Work</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Rate - trends</subject><subject>Treatment Outcome</subject><subject>Tricuspid atresia</subject><subject>Veins & arteries</subject><subject>Ventricle</subject><issn>1047-9511</issn><issn>1467-1107</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kE1LJDEQhoOs6OzoD_Aigb3spddUku50vCwi-yEMLOzouUmnKzOR_hiT7pX59xudUcFlL1UF9bxvFS8hZ8C-AAN1sQQmlc4BQDPGQPMDMgNZqAyAqQ9pTuvsaX9MPsZ4nxAhgB2R41RlUeZyRn4vp7DCsKWDo9H3qxbpH-zH4G2LkfqerqfO9H40wZueboKxo7d4SeNe5oZAH9ferunGjD4p49cTcuhMG_F03-fk7vu32-uf2eLXj5vrq0VmhRJjJgFzVzeNQM14UZbIc62BG4WSu8I1JTJbNNYqrXKpFXJTM6dcWQisyzovxZx83vluwvAwYRyrzkeLbWt6HKZYcc41F7l8Rj-9Q--HKfTpu4oLVgDXWshEwY6yYYgxoKs2wXcmbCtg1VPg1T-BJ8353nmqO2xeFS8JJ0DsTU1XB9-s8O32_23_Auv3ieg</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Gouton, Marielle</creator><creator>Bical, Olivier Michel</creator><creator>Zoghbi, Joy</creator><creator>Roussin, Régine</creator><creator>Lucet, Vincent</creator><creator>Leca, Francine</creator><general>Cambridge University Press</general><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>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201905</creationdate><title>Surgery of single ventricles in humanitarian practice: surgery for which patients?</title><author>Gouton, Marielle ; 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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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