Optimal Z-Score Use in Surgical Decision-Making in Pulmonary Atresia With Intact Ventricular Septum

World Journal for Pediatric & Congenital Heart Surgery
Mark Nelson AworiNaomi Kebba

Abstract

In the surgical treatment of pulmonary atresia with intact ventricular septum, the size of the tricuspid valve annulus (as measured by z-scores) has emerged as a significant factor in deciding which repair to perform. Various tricuspid valve annulus z-scores are reported as "cutoffs" for successful biventricular repair. We aimed to determine whether the use of different z-score data sets contributed to the gross variation in "cutoffs" for successful biventricular repair reported in the literature. A single search was made of PubMed using the "advanced" setting with the following search terms: pulmonary, atresia, intact, septum, z, and score. The filters "title" and "title/abstract" were used for the first four and last two terms, respectively; the instruction "AND" combined all terms. Articles that identified which z-score data set was used in patients with biventricular repairs were included. From 13 articles, 1,392 patients were studied, 410 (29.5%) of which achieved biventricular repair. Three z-score data sets were quoted; mean tricuspid valve annulus z-scores in biventricular repair patients ranged between -0.53 and -5.1. After correcting for discrepancies between z-score data sets, no study reported a mean tricuspid valve...Continue Reading

References

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Citations

Oct 20, 2017·Seminars in Cardiothoracic and Vascular Anesthesia·Stephen GleichFaith J Ross
Feb 8, 2018·Seminars in Cardiothoracic and Vascular Anesthesia·Sathish M ChikkabyrappaJustin T Tretter
Apr 27, 2018·World Journal for Pediatric & Congenital Heart Surgery·Mark Nelson AworiNaomi Kebba
Jan 31, 2020·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Hyun Woo Goo
Aug 24, 2020·The Annals of Thoracic Surgery·Elizabeth H StephensJoseph A Dearani
Jul 8, 2020·Fetal Diagnosis and Therapy·Whitnee J HoganUNKNOWN for the IFCIR Participants

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