Arteriovenous fistula creation for hypoxia after single ventricle palliation: A single-institution experience and literature review

Congenital Heart Disease
Andrew D SpearmanSalil Ginde

Abstract

Hypoxia is a common and sometimes severe morbidity of single ventricle congenital heart disease (CHD). Creation of an arteriovenous fistula (AVF) is occasionally performed for patients after superior or total cavopulmonary connection (SCPC or TCPC) in an attempt to improve oxygen saturations. Despite previous reports, AVF creation is a rare palliation with inadequately defined benefits and risks. We sought to determine changes in peripheral oxygen saturation (SpO2 ) and risk of adverse event after AVF creation in children with single ventricle CHD at our institution. We conducted a retrospective chart review of patients with a history of single ventricle palliation and history of surgical AVF creation who were seen at our tertiary care center from 1996 to 2017. A total of seven patients were included in our study. SpO2 for the overall cohort did not significantly increase after AVF creation (pre-AVF 79.1 ± 6.9%, post-AVF 82.7 ± 6.0% [P = .23]). SpO2 trended up for large shunts (>5 mm) (pre-AVF 75.0 ± 7.6%, post-AVF 84.0 ± 5.3% [P = .25]). SpO2 did not improve for small shunts (≤5 mm) (pre-AVF 82.3 ± 6.5%, post-AVF 81.0 ± 8.5% [P = .50]). The 12-month overall and transplant-free survival were 85.7% and 71.4%, respectively. Freed...Continue Reading

References

Jan 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·A MageeR M Freedom
Nov 5, 2008·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·G PupelisA Suhova
Nov 20, 2009·The Journal of Thoracic and Cardiovascular Surgery·Edward J HickeyWilliam G Williams
Jul 14, 2010·The Journal of Thoracic and Cardiovascular Surgery·Luis G QuiñonezFrancisco J Puga
Jul 24, 2012·Journal of the American College of Cardiology·Lindsay S RogersDavid J Goldberg
Mar 1, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ajay J IyengarUNKNOWN Australia and New Zealand Fontan Registry
Apr 15, 2015·World Journal for Pediatric & Congenital Heart Surgery·Nitin ChananaPhillip T Burch
Jun 4, 2016·International Journal of Cardiology·Chris SchillingYves d'Udekem

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Citations

Mar 9, 2021·Annals of Pediatric Cardiology·Ibrahim J AlibrahimFahad Alhabshan
Jul 27, 2021·World Journal for Pediatric & Congenital Heart Surgery·Diana M Torpoco RiveraDaisuke Kobayashi

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