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- Title:
Impact of aorto-pulmonary and veno-venous collaterals on the onset of plastic bronchitis following the Fontan procedure.
- Document type:
- Journal Article
- Author(s):
- Osawa, Takuya; Schaeffer, Thibault; Schmiel, Mervin; Hoa Nguyen Cong, Michelle Bao; Niedermaier, Carolin; Heinisch, Paul Philipp; Piber, Nicole; Georgiev, Stanimir; Hager, Alfred; Ewert, Peter; Hörer, Jürgen; Ono, Masamichi
- Abstract:
- OBJECTIVE: This study aimed to clarify the association of the aorto-pulmonary/veno-venous collaterals in patients with plastic bronchitis after the Fontan procedure. METHODS: All patients who underwent total cavopulmonary connection from 1994 to 2022 were reviewed. Aorto-pulmonary/veno-venous collaterals were detected using angiograms. The impact of aorto-pulmonary/veno-venous collaterals as well as other variables on the onset of plastic bronchitis were evaluated. RESULTS: A total of 635 patients were included. Plastic bronchitis was observed in 15 (2.4%) patients and the median duration between total cavopulmonary connection and the onset of plastic bronchitis was 1.1 years. Freedom from plastic bronchitis at 5 and 10 years was 97.5 and 96.5%, respectively. As for the association of PB and APCs/VVCs, patients with PB had an increased incidence of post-TCPC APCs (60 vs. 14%, p<0.001) and VVCs (53 vs. 14%, p<0.001). The freedom from plastic bronchitis was the lowest in the patients who were associated with both aortopulmonary collaterals and veno-venous collaterals after total cavopulmonary connection. Aortopulmonary collaterals after total cavopulmonary connection (p=0.002, hazard ratio: 5.729), veno-venous collaterals after total cavopulmonary connection (p=0.016, hazard ratio: 3.527), and chylothorax (p=0.019, hazard ratio: 3.662) were identified as independently associated factors with the onset of plastic bronchitis. CONCLUSIONS: The occurrence of post-Fontan aortopulmonary and veno-venous collaterals was significantly associated with the development of plastic bronchitis. Treatment or mitigation of collaterals may represent an opportunity to prevent the development of plastic bronchitis, a remaining source of post-Fontan excess morbidity and mortality.
- Journal title abbreviation:
- J Thorac Cardiovasc Surg
- Year:
- 2024
- Fulltext / DOI:
- doi:10.1016/j.jtcvs.2024.09.049
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/39384081
- Print-ISSN:
- 0022-5223
- TUM Institution:
- Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (DHM) (Prof. Hörer); Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane)
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