Journal article
Procedural Outcomes of Pulmonary Atresia With Intact Ventricular Septum in Neonates: A Multicenter Study
The Annals of thoracic surgery, Vol.115(6), pp.1470-1477
06/2023
DOI: 10.1016/j.athoracsur.2022.07.055
PMID: 36070807
Abstract
Multicenter contemporary data describing short-term outcomes after initial interventions of neonates with pulmonary atresia with intact ventricular septum (PA-IVS) are limited. This multicenter study describes characteristics and outcomes of PA-IVS neonates after their initial catheter or surgical intervention and identifies factors associated with major adverse cardiac events (MACE).
Neonates with PA-IVS who underwent surgical or catheter intervention between 2009 and 2019 in 19 centers were reviewed. Risk factors for MACE, defined as cardiopulmonary resuscitation, mechanical circulatory support, stroke, or in-hospital mortality, were analyzed using multivariable logistic regression models.
We reviewed 279 neonates: 79 (28%) underwent right ventricular decompression, 151 (54%) underwent systemic-to-pulmonary shunt or ductal stent placement only, 36 (13%) underwent right ventricular decompression with shunt or ductal stent placement, and 11 (4%) underwent transplantation. MACE occurred in 57 patients (20%): 26 (9%) received mechanical circulatory support, 37 (13%) received cardiopulmonary resuscitation, stroke occurred in 16 (6%), and 23 (8%) died. The presence of 2 major coronary artery stenoses (adjusted odds ratio, 4.99; 95% CI, 1.16-21.39) and lower weight at first intervention (adjusted odds ratio, 1.52; 95% CI, 1.01-2.27) were significantly associated with MACE. Coronary ischemia was the most frequent presumed mechanism of death (n = 10).
In a multicenter cohort, 1 in 5 neonates with PA-IVS experienced MACE after their initial intervention. Patients with 2 major coronary artery stenoses or lower weight at the time of the initial procedure were most likely to experience MACE and warrant vigilance during preintervention planning and postintervention management.
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Details
- Title: Subtitle
- Procedural Outcomes of Pulmonary Atresia With Intact Ventricular Septum in Neonates: A Multicenter Study
- Creators
- Eva W. Cheung - Columbia UniversityChristopher W. Mastropietro - Riley Hospital for ChildrenSaul Flores - Baylor College of MedicineVenugopal Amula - University of Utah Health CareMonique Radman - Seattle Children's HospitalDavid Kwiatkowski - Lucile Packard Children's HospitalBao Nguyen Puente - Children's NationalJason R. Buckley - Medical University of South CarolinaKiona Allen - Lurie Children's HospitalRohit Loomba - Advocate Children's HospitalKaran Karki - University of Tennessee Health Science CenterSaurabh Chiwane - Cardinal Glennon Children's HospitalKatherine Cashen - Duke University HospitalKurt Piggott - Children's Hospital of New OrleansYamini Kapileshwarkar - Children's Hospital of IllinoisKeshava Murthy Narayana Gowda - Cleveland ClinicAditya Badheka - University of IowaRahul Raman - Mercy Medical CenterJohn M. Costello - Medical University of South CarolinaHuaiyu Zang - Cincinnati Children's Hospital Medical CenterIlias Iliopoulos - Cincinnati Children's Hospital Medical CenterCollaborative Research from the Pediatric Cardiac Intensive Care Society (CoRe-PCICS) Investigators
- Resource Type
- Journal article
- Publication Details
- The Annals of thoracic surgery, Vol.115(6), pp.1470-1477
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.athoracsur.2022.07.055
- PMID
- 36070807
- ISSN
- 0003-4975
- eISSN
- 1552-6259
- Language
- English
- Electronic publication date
- 09/2022
- Date published
- 06/2023
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics
- Record Identifier
- 9984354157902771
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