Journal article
Frequency of Superior Vena Cava Obstruction in Pediatric Heart Transplant Recipients and Its Relation to Previous Superior Cavopulmonary Anastomosis
The American journal of cardiology, Vol.112(2), pp.286-291
07/15/2013
DOI: 10.1016/j.amjcard.2013.03.029
PMCID: PMC6118126
PMID: 23587279
Abstract
The risk factors for superior vena cava (SVC) obstruction after pediatric orthotopic heart transplantation (OHT) have not been identified. This study tested the hypothesis that pretransplant superior cavopulmonary anastomosis (CPA) predisposes patients to SVC obstruction. A retrospective review of the Pediatric Cardiac Care Consortium registry from 1982 through 2007 was performed. Previous CPA, other cardiac surgeries, gender, age at transplantation, and weight at transplantation were assessed for the risk of developing SVC obstruction. Death, subsequent OHT, or reoperation involving the SVC were treated as competing risks. Of the 894 pediatric OHT patients identified, 3.1% (n = 28) developed SVC obstruction during median follow-up of 1.0 year (range: 0 to 19.5 years). Among patients who developed SVC obstruction, 32% (n = 9) had pretransplant CPA. SVC surgery before OHT was associated with posttransplant development of SVC obstruction (p <0.001) after adjustment for gender, age, and weight at OHT and year of OHT. Patients with previous CPA had increased risk for SVC obstruction compared with patients with no history of previous cardiac surgery (hazard ratio 10.6, 95% confidence interval: 3.5 to 31.7) and to patients with history of non-CPA cardiac surgery (hazard ratio 4.7, 95% confidence interval: 1.8 to 12.5). In conclusion, previous CPA is a significant risk factor for the development of post–heart transplant SVC obstruction.
Details
- Title: Subtitle
- Frequency of Superior Vena Cava Obstruction in Pediatric Heart Transplant Recipients and Its Relation to Previous Superior Cavopulmonary Anastomosis
- Creators
- Osamah Aldoss - Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MinnesotaNofil I Arain - Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MinnesotaJeffrey M Vinocur - Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MinnesotaJeremiah Menk - Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, MinnesotaRebecca K Ameduri - Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MinnesotaRoosevelt Bryant - Department of Surgery, University of Minnesota, Minneapolis, MinnesotaLazaros K Kochilas - Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, MinnesotaDaniel H Gruenstein - Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, Minnesota
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.112(2), pp.286-291
- DOI
- 10.1016/j.amjcard.2013.03.029
- PMID
- 23587279
- PMCID
- PMC6118126
- NLM abbreviation
- Am J Cardiol
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 07/15/2013
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9984093234502771
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