Factors associated with mortality or transplantation versus Fontan completion after cavopulmonary shunt for patients with tricuspid atresia

Tricuspid atresia with normally related great vessels (TA) is considered the optimal substrate for the Fontan pathway. The factors associated with death or transplantation after cavopulmonary shunt (CPS) are underappreciated. We aimed to determine factors associated with CPS–Fontan interstage death/...

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Veröffentlicht in:The Journal of thoracic and cardiovascular surgery 2022-02, Vol.163 (2), p.399-409.e6
Hauptverfasser: Callahan, Connor P., Jegatheeswaran, Anusha, Barron, David J., Husain, S. Adil, Eghtesady, Pirooz, Welke, Karl F., Caldarone, Christopher A., Overman, David M., Kirklin, James K., Jacobs, Marshall L., Lambert, Linda M., DeCampli, William M., McCrindle, Brian W., Abarbanell, Aaron M., Gruber, Peter J., Karamlou, Tara, Lambert, Linda, Meyer, David B., Pizarro, Christian, Ramakrishnan, Karthik, St Louis, James D., Zadokar, Varsha
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Sprache:eng
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Zusammenfassung:Tricuspid atresia with normally related great vessels (TA) is considered the optimal substrate for the Fontan pathway. The factors associated with death or transplantation after cavopulmonary shunt (CPS) are underappreciated. We aimed to determine factors associated with CPS–Fontan interstage death/transplantation versus transition to Fontan in TA. A total of 417 infants younger than 3 months of age with TA were enrolled (January 1999 to February 2020) from 40 institutions into the Congenital Heart Surgeons' Society TA cohort. Parametric competing risk methodology was used to determine factors associated with the competing end points of death/transplantation without Fontan completion, and transition to Fontan. CPS was performed in 382 patients with TA; of those, 5% died or underwent transplantation without transition to Fontan and 91% transitioned to Fontan by 5 years after CPS. Prenatal diagnosis (hazard ratio [HR], 0.74; P 
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2021.04.061