Mid-term results of bidirectional cavopulmonary anastomosis in adult patients with functionally single ventricle
- #CH/ADU 01-EP-2
- Congenital Heart Surgery/Adult Congenital Cardiac. E-POSTER (ORAL) SESSION
- E-Poster (oral)
Mid-term results of bidirectional cavopulmonary anastomosis in adult patients with functionally single ventricle
Dmitry Kovalev, Vladimir Podzolkov, Ivan Yurlov, Victor Samsonov, Tatyana Astrakhantseva, Anton Minaev, Nikolay Chikin, Vera Dontsova, Olga Medvedeva
A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia
Date, time and location: 2018.05.26 15:30, Exhibition area, 1st Floor. Zone – D
Abstract
METHODS: From 1981 to 2017, 350 patients underwent BCPC in our institution. Thirty eight of them (10.8%) were older than 18 years (mean 25±6.4 years). The diagnoses were double inlet ventricle-15 patients, tricuspid atresia-7, complex corrected transposition of great arteries - 4, heterotaxy syndrome -3, unbalanced complete atrioventricular canal-2 and another-7. The arterial blood oxygen saturation (SatO2) was - 71,5±7.8%, Hb - 181.6±44.6 g/l, pulmonary arterial index 364.0±105.5 mm2 / m2, the McGoon index - 1.69 ± 0.52, mean pulmonary pressure -13.6±3.5 mm Hg, the ejection fraction (EF) of single ventricle was 58 ± 6.8% before surgery. Thirty patients corresponded to 3 FC, 8 patients – 4 FC NYHA.
RESULTS: Hospital mortality was 5.2% (2/38) due to multiple organ dysfunction and intraoperative bleeding and 2 late deaths due to comorbid pathology. Examination of thirty patients at mid-term follow up (mean 5.3±4.9 years) showed the SatO2 83 ± 5.7% (p <0.01), EF - 51.6 ± 7.8% (p>0.05). 23 patients corresponded to 1-2 FC and 7 in 3-4 FC NYHA. Eight patients were selected for Fontan operation, a high risk for Fontan completion due to a combination of low EF, severe arterial hypoxemia and polycythemia, hypoplasia of the pulmonary artery branches, severe atrioventricular valves regurgitation and/or concomitant somatic diseases were revealed in 22, in one of them successful axillary arteriovenous fistula was performed.
CONCLUSIONS:BCPC in adults is accompanied by good mid-term results and considerable improvement of patients’ state. Axillary arteriovenous fistula may be considered as a stage of surgical correction.