Indications and results of systemic to pulmonary shunts: results from a national database

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Dan Mihai DorobantuSerban Constantin Stoica

Abstract

The systemic-to-pulmonary shunt (SPS) remains an important palliative therapy in many congenital heart defects. Unlike other surgical treatments, the mortality after shunt operations has risen. We used an audit dataset to investigate potential reasons for this change and to report national results. A total of 1993 patients classified in 13 diagnoses underwent an SPS procedure between 2000 and 2013. Indication trends by era and also results before repair or next stage are reported. A dynamic hazard model with competing risks and modulated renewal was used to determine predictors of outcomes. The usage of SPS in Tetralogy of Fallot (ToF) has significantly decreased in the last decade, with cases of single ventricle (SV) and pulmonary atresia (PA) with septal communication increasing (P < 0.001 for trends). This is correlated with an increase of early mortality from 5.1% in the first half of the decade to 9.8% in the latter (P = 0.007 for trend). At 1.5 years, 13.9% of patients have died, 17.8% had a shunt reintervention and 68.3% of patients are alive and reintervention-free. Low weight, PA-intact septum, SV and central shunt type are among the factors associated with increased mortality, whereas PA-ventricular septal defect, cor...Continue Reading

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Citations

Jul 6, 2016·Frontiers in Pediatrics·Worakan Promphan, Shakeel A Qureshi
Jan 13, 2017·Cardiology in the Young·Julien I E Hoffman
Jul 25, 2017·Congenital Heart Disease·Navaneetha SasikumarLee Benson
Apr 19, 2019·Open Heart·Dan Mihai DorobantuSerban Constantin Stoica
Mar 22, 2020·Scientific Reports·Kanthalas LertsakulpiriyaSomchai Sriyoschati
Nov 27, 2019·Pediatric Cardiology·Joana A SilvaHercília Guimarães
May 27, 2020·Seminars in Cardiothoracic and Vascular Anesthesia·Madhusudan GanigaraSathish M Chikkabyrappa
Aug 28, 2020·The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology·Arun GopalakrishnanKavassery Mahadevan Krishnamoorthy
Nov 23, 2019·Archives of Cardiovascular Diseases·Estibaliz ValdeomillosUNKNOWN Filiale de cardiologie pédiatrique et congénitale de la Société française de cardiologie
Sep 9, 2020·The Annals of Thoracic Surgery·Eung Re KimJae Gun Kwak
Mar 10, 2021·Circulation. Cardiovascular Interventions·Kanishka RatnayakaHowaida G El-Said
Jul 28, 2019·The Journal of Thoracic and Cardiovascular Surgery·Tomislav SantroJohann Brink

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