Risk factors for failed staged palliation after bidirectional Glenn in infants who have undergone stage one palliation
Abstract Objective: The bidirectional Glenn procedure (BDG) is a routine intermediary step in single-ventricle palliation. In this study, we examined risk factors for death or transplant and failure to reach Fontan completion after BDG in patients, who had previously undergone stage one palliation (...
Gespeichert in:
| Veröffentlicht in: | European journal of cardio-thoracic surgery 2011-10, Vol.40 (4), p.1000-1006, Article 1000 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1006 |
|---|---|
| container_issue | 4 |
| container_start_page | 1000 |
| container_title | European journal of cardio-thoracic surgery |
| container_volume | 40 |
| creator | Friedman, Kevin G. Salvin, Joshua W. Wypij, David Gurmu, Yared Bacha, Emile A. Brown, David W. Laussen, Peter C. Scheurer, Mark A. |
| description | Abstract
Objective: The bidirectional Glenn procedure (BDG) is a routine intermediary step in single-ventricle palliation. In this study, we examined risk factors for death or transplant and failure to reach Fontan completion after BDG in patients, who had previously undergone stage one palliation (S1P). Methods: All patients at our institution, who underwent BDG following S1P between 2002 and 2009 (n = 194), were included in the analysis. Results: Transplant-free survival through 18 months post BDG was 91%. Univariable competing risk analyses showed atrioventricular valve regurgitation (AVVR) >mild, age ≤3 months at BDG, ventricular dysfunction >mild, and prolonged hospital stay after S1P to be associated with increased risk of death or orthotopic heart transplant. Multivariable competing risk analysis through 5 years of follow-up showed >mild AVVR (hazard ratio (HR) 7.5, 95% confidence interval (CI) 3.0-18.8), prolonged hospitalization after S1P (HR 4.5, 95% CI 1.8-11.5), and age ≤3 months at BDG (HR 6.8, 95% CI 2.3-20.0) to be independent risk factors for death or transplant. Concomitantly, >mild AVVR and age ≤3 months were independently associated with an overall decreased rate of Fontan completion. Conclusions: Pre-BDG AVVR, age ≤3 months at time of BDG, and prolonged hospitalization after S1P are independently associated with decreased successful progression of staged palliation in midterm follow-up after BDG. |
| doi_str_mv | 10.1016/j.ejcts.2011.01.056 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3376531</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1016/j.ejcts.2011.01.056</oup_id><sourcerecordid>892945549</sourcerecordid><originalsourceid>FETCH-LOGICAL-c473t-5c4a88769c8ab7937ee5d3b31d3e37dadca2b958ae205b18448d2ed4f29eedc43</originalsourceid><addsrcrecordid>eNqNUcGKFDEQbURx19UvECQX8dRt0kk6nYsgi67CgiAK3kJ1Uj2TMdMZk54R_970zrirXhQKqqi8evVSr6qeMtowyrqXmwY3ds5NSxlraAnZ3avOWa94rbj4cr_UlNFaaUHPqkc5byilHW_Vw-qsZVypXrfn1eGjz1_JCHaOKZMxplL7gI7kGVYl7SAED7OPE4FxxkQG73xCu3QgkKuA00T8EiNMcybf15Gs4YBkPzlMqzjhkYks1R3Z4-rBCCHjk1O-qD6_ffPp8l19_eHq_eXr69oKxedaWgF9rzptexiU5gpROj5w5jhy5cBZaActe8CWyoH1QvSuRSfGViM6K_hF9erIu9sP29LBaU4QzC75LaQfJoI3f75Mfm1W8WA4V53krBC8OBGk-G2PeTZbny2GABPGfTbliFpIKXRB8iPSpphzwvF2C6NmMcxszI1hZjHM0BKyK1PPfhd4O_PLoQJ4fgJAthDGBJP1-Q4npNKy5QWn_1pv_Xxz6_IvH_4hojnOxv3uv1T_BAiuxok</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>892945549</pqid></control><display><type>article</type><title>Risk factors for failed staged palliation after bidirectional Glenn in infants who have undergone stage one palliation</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Friedman, Kevin G. ; Salvin, Joshua W. ; Wypij, David ; Gurmu, Yared ; Bacha, Emile A. ; Brown, David W. ; Laussen, Peter C. ; Scheurer, Mark A.</creator><creatorcontrib>Friedman, Kevin G. ; Salvin, Joshua W. ; Wypij, David ; Gurmu, Yared ; Bacha, Emile A. ; Brown, David W. ; Laussen, Peter C. ; Scheurer, Mark A.</creatorcontrib><description>Abstract
Objective: The bidirectional Glenn procedure (BDG) is a routine intermediary step in single-ventricle palliation. In this study, we examined risk factors for death or transplant and failure to reach Fontan completion after BDG in patients, who had previously undergone stage one palliation (S1P). Methods: All patients at our institution, who underwent BDG following S1P between 2002 and 2009 (n = 194), were included in the analysis. Results: Transplant-free survival through 18 months post BDG was 91%. Univariable competing risk analyses showed atrioventricular valve regurgitation (AVVR) >mild, age ≤3 months at BDG, ventricular dysfunction >mild, and prolonged hospital stay after S1P to be associated with increased risk of death or orthotopic heart transplant. Multivariable competing risk analysis through 5 years of follow-up showed >mild AVVR (hazard ratio (HR) 7.5, 95% confidence interval (CI) 3.0-18.8), prolonged hospitalization after S1P (HR 4.5, 95% CI 1.8-11.5), and age ≤3 months at BDG (HR 6.8, 95% CI 2.3-20.0) to be independent risk factors for death or transplant. Concomitantly, >mild AVVR and age ≤3 months were independently associated with an overall decreased rate of Fontan completion. Conclusions: Pre-BDG AVVR, age ≤3 months at time of BDG, and prolonged hospitalization after S1P are independently associated with decreased successful progression of staged palliation in midterm follow-up after BDG.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1016/j.ejcts.2011.01.056</identifier><identifier>PMID: 21377892</identifier><identifier>CODEN: EJCSE7</identifier><language>eng</language><publisher>Oxford: Elsevier Science B.V</publisher><subject>Age Factors ; Biological and medical sciences ; Cardiology. Vascular system ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Female ; Follow-Up Studies ; Fontan Procedure - methods ; Heart ; Heart Transplantation ; Humans ; Hypoplastic Left Heart Syndrome - pathology ; Hypoplastic Left Heart Syndrome - surgery ; Infant ; Length of Stay - statistics & numerical data ; Male ; Medical sciences ; Palliative Care - methods ; Pneumology ; Risk Factors ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Treatment Failure ; Treatment Outcome</subject><ispartof>European journal of cardio-thoracic surgery, 2011-10, Vol.40 (4), p.1000-1006, Article 1000</ispartof><rights>European Association for Cardio-Thoracic Surgery © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. 2011</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.</rights><rights>2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-5c4a88769c8ab7937ee5d3b31d3e37dadca2b958ae205b18448d2ed4f29eedc43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,886,27926,27927</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24579523$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21377892$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Friedman, Kevin G.</creatorcontrib><creatorcontrib>Salvin, Joshua W.</creatorcontrib><creatorcontrib>Wypij, David</creatorcontrib><creatorcontrib>Gurmu, Yared</creatorcontrib><creatorcontrib>Bacha, Emile A.</creatorcontrib><creatorcontrib>Brown, David W.</creatorcontrib><creatorcontrib>Laussen, Peter C.</creatorcontrib><creatorcontrib>Scheurer, Mark A.</creatorcontrib><title>Risk factors for failed staged palliation after bidirectional Glenn in infants who have undergone stage one palliation</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><addtitle>Eur J Cardiothorac Surg</addtitle><description>Abstract
Objective: The bidirectional Glenn procedure (BDG) is a routine intermediary step in single-ventricle palliation. In this study, we examined risk factors for death or transplant and failure to reach Fontan completion after BDG in patients, who had previously undergone stage one palliation (S1P). Methods: All patients at our institution, who underwent BDG following S1P between 2002 and 2009 (n = 194), were included in the analysis. Results: Transplant-free survival through 18 months post BDG was 91%. Univariable competing risk analyses showed atrioventricular valve regurgitation (AVVR) >mild, age ≤3 months at BDG, ventricular dysfunction >mild, and prolonged hospital stay after S1P to be associated with increased risk of death or orthotopic heart transplant. Multivariable competing risk analysis through 5 years of follow-up showed >mild AVVR (hazard ratio (HR) 7.5, 95% confidence interval (CI) 3.0-18.8), prolonged hospitalization after S1P (HR 4.5, 95% CI 1.8-11.5), and age ≤3 months at BDG (HR 6.8, 95% CI 2.3-20.0) to be independent risk factors for death or transplant. Concomitantly, >mild AVVR and age ≤3 months were independently associated with an overall decreased rate of Fontan completion. Conclusions: Pre-BDG AVVR, age ≤3 months at time of BDG, and prolonged hospitalization after S1P are independently associated with decreased successful progression of staged palliation in midterm follow-up after BDG.</description><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fontan Procedure - methods</subject><subject>Heart</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>Hypoplastic Left Heart Syndrome - pathology</subject><subject>Hypoplastic Left Heart Syndrome - surgery</subject><subject>Infant</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Palliative Care - methods</subject><subject>Pneumology</subject><subject>Risk Factors</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUcGKFDEQbURx19UvECQX8dRt0kk6nYsgi67CgiAK3kJ1Uj2TMdMZk54R_970zrirXhQKqqi8evVSr6qeMtowyrqXmwY3ds5NSxlraAnZ3avOWa94rbj4cr_UlNFaaUHPqkc5byilHW_Vw-qsZVypXrfn1eGjz1_JCHaOKZMxplL7gI7kGVYl7SAED7OPE4FxxkQG73xCu3QgkKuA00T8EiNMcybf15Gs4YBkPzlMqzjhkYks1R3Z4-rBCCHjk1O-qD6_ffPp8l19_eHq_eXr69oKxedaWgF9rzptexiU5gpROj5w5jhy5cBZaActe8CWyoH1QvSuRSfGViM6K_hF9erIu9sP29LBaU4QzC75LaQfJoI3f75Mfm1W8WA4V53krBC8OBGk-G2PeTZbny2GABPGfTbliFpIKXRB8iPSpphzwvF2C6NmMcxszI1hZjHM0BKyK1PPfhd4O_PLoQJ4fgJAthDGBJP1-Q4npNKy5QWn_1pv_Xxz6_IvH_4hojnOxv3uv1T_BAiuxok</recordid><startdate>20111001</startdate><enddate>20111001</enddate><creator>Friedman, Kevin G.</creator><creator>Salvin, Joshua W.</creator><creator>Wypij, David</creator><creator>Gurmu, Yared</creator><creator>Bacha, Emile A.</creator><creator>Brown, David W.</creator><creator>Laussen, Peter C.</creator><creator>Scheurer, Mark A.</creator><general>Elsevier Science B.V</general><general>Oxford University Press</general><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><scope>5PM</scope></search><sort><creationdate>20111001</creationdate><title>Risk factors for failed staged palliation after bidirectional Glenn in infants who have undergone stage one palliation</title><author>Friedman, Kevin G. ; Salvin, Joshua W. ; Wypij, David ; Gurmu, Yared ; Bacha, Emile A. ; Brown, David W. ; Laussen, Peter C. ; Scheurer, Mark A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-5c4a88769c8ab7937ee5d3b31d3e37dadca2b958ae205b18448d2ed4f29eedc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Age Factors</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fontan Procedure - methods</topic><topic>Heart</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>Hypoplastic Left Heart Syndrome - pathology</topic><topic>Hypoplastic Left Heart Syndrome - surgery</topic><topic>Infant</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Palliative Care - methods</topic><topic>Pneumology</topic><topic>Risk Factors</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Friedman, Kevin G.</creatorcontrib><creatorcontrib>Salvin, Joshua W.</creatorcontrib><creatorcontrib>Wypij, David</creatorcontrib><creatorcontrib>Gurmu, Yared</creatorcontrib><creatorcontrib>Bacha, Emile A.</creatorcontrib><creatorcontrib>Brown, David W.</creatorcontrib><creatorcontrib>Laussen, Peter C.</creatorcontrib><creatorcontrib>Scheurer, Mark A.</creatorcontrib><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><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Friedman, Kevin G.</au><au>Salvin, Joshua W.</au><au>Wypij, David</au><au>Gurmu, Yared</au><au>Bacha, Emile A.</au><au>Brown, David W.</au><au>Laussen, Peter C.</au><au>Scheurer, Mark A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for failed staged palliation after bidirectional Glenn in infants who have undergone stage one palliation</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><stitle>Eur J Cardiothorac Surg</stitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2011-10-01</date><risdate>2011</risdate><volume>40</volume><issue>4</issue><spage>1000</spage><epage>1006</epage><pages>1000-1006</pages><artnum>1000</artnum><issn>1010-7940</issn><eissn>1873-734X</eissn><coden>EJCSE7</coden><abstract>Abstract
Objective: The bidirectional Glenn procedure (BDG) is a routine intermediary step in single-ventricle palliation. In this study, we examined risk factors for death or transplant and failure to reach Fontan completion after BDG in patients, who had previously undergone stage one palliation (S1P). Methods: All patients at our institution, who underwent BDG following S1P between 2002 and 2009 (n = 194), were included in the analysis. Results: Transplant-free survival through 18 months post BDG was 91%. Univariable competing risk analyses showed atrioventricular valve regurgitation (AVVR) >mild, age ≤3 months at BDG, ventricular dysfunction >mild, and prolonged hospital stay after S1P to be associated with increased risk of death or orthotopic heart transplant. Multivariable competing risk analysis through 5 years of follow-up showed >mild AVVR (hazard ratio (HR) 7.5, 95% confidence interval (CI) 3.0-18.8), prolonged hospitalization after S1P (HR 4.5, 95% CI 1.8-11.5), and age ≤3 months at BDG (HR 6.8, 95% CI 2.3-20.0) to be independent risk factors for death or transplant. Concomitantly, >mild AVVR and age ≤3 months were independently associated with an overall decreased rate of Fontan completion. Conclusions: Pre-BDG AVVR, age ≤3 months at time of BDG, and prolonged hospitalization after S1P are independently associated with decreased successful progression of staged palliation in midterm follow-up after BDG.</abstract><cop>Oxford</cop><pub>Elsevier Science B.V</pub><pmid>21377892</pmid><doi>10.1016/j.ejcts.2011.01.056</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1010-7940 |
| ispartof | European journal of cardio-thoracic surgery, 2011-10, Vol.40 (4), p.1000-1006, Article 1000 |
| issn | 1010-7940 1873-734X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3376531 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Age Factors Biological and medical sciences Cardiology. Vascular system Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Female Follow-Up Studies Fontan Procedure - methods Heart Heart Transplantation Humans Hypoplastic Left Heart Syndrome - pathology Hypoplastic Left Heart Syndrome - surgery Infant Length of Stay - statistics & numerical data Male Medical sciences Palliative Care - methods Pneumology Risk Factors Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Treatment Failure Treatment Outcome |
| title | Risk factors for failed staged palliation after bidirectional Glenn in infants who have undergone stage one palliation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-18T13%3A21%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20factors%20for%20failed%20staged%20palliation%20after%20bidirectional%20Glenn%20in%20infants%20who%20have%20undergone%20stage%20one%20palliation&rft.jtitle=European%20journal%20of%20cardio-thoracic%20surgery&rft.au=Friedman,%20Kevin%20G.&rft.date=2011-10-01&rft.volume=40&rft.issue=4&rft.spage=1000&rft.epage=1006&rft.pages=1000-1006&rft.artnum=1000&rft.issn=1010-7940&rft.eissn=1873-734X&rft.coden=EJCSE7&rft_id=info:doi/10.1016/j.ejcts.2011.01.056&rft_dat=%3Cproquest_pubme%3E892945549%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=892945549&rft_id=info:pmid/21377892&rft_oup_id=10.1016/j.ejcts.2011.01.056&rfr_iscdi=true |