Impact of veno-venous collaterals on outcome after the total cavopulmonary connection.

Cong, Michelle Bao Hoa Nguyen; Schaeffer, Thibault; Osawa, Takuya; Palm, Jonas; Georgiev, Stanimir; Di Padua, Chiara; Niedermaier, Carolin; Heinisch, Paul Philipp; Piber, Nicole; Hager, Alfred; Ewert, Peter; Hörer, Jürgen; Ono, Masamichi

doi:10.1016/j.ijcard.2024.132229

Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane)

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Title:: Impact of veno-venous collaterals on outcome after the total cavopulmonary connection.
Document type:: Journal Article
Author(s):: Cong, Michelle Bao Hoa Nguyen; Schaeffer, Thibault; Osawa, Takuya; Palm, Jonas; Georgiev, Stanimir; Di Padua, Chiara; Niedermaier, Carolin; Heinisch, Paul Philipp; Piber, Nicole; Hager, Alfred; Ewert, Peter; Hörer, Jürgen; Ono, Masamichi
Abstract:: OBJECTIVE: To evaluate the prevalence of veno-venous collaterals (VVCs) after total cavopulmonary connection (TCPC) and analyze their impact on outcomes. METHODS: Patients undergoing TCPC between 1994 and 2022 were evaluated. VVCs were identified using angiograms of cardiac catheterizations and their impact on outcomes was analyzed. RESULTS: A total of 635 patients were included. Median age at TCPC was 2.3 (interquartile ranges (IQR): 1.8-3.3) years. The most frequent diagnosis was hypoplastic left heart syndrome in 173 (27.2%) patients. Prior bidirectional cavopulmonary shunt was performed in 586 (92.3%) patients at a median age of 5.3 (3.6-9.9) months. VVCs were found in 94 (14.8%) patients at a median of 2.8 (0.1-11.8) years postoperatively. The prevalence of VVCs was similar between the dominant right and left ventricle (14.7 vs. 14.9%, p = 0.967). Mean pulmonary artery pressure (16.2 vs. 16.0 mmHg, p = 0.902), left atrial pressure (5.5 vs. 5.7 mmHg, p = 0.480), transpulmonary gradient (4.0 vs. 3.8 mmHg, p = 0.554) and oxygen saturation (81.4 vs. 82.6%, p = 0.103) before TCPC were similar between patients with and without VVCs. The development of VVCs did not affect survival after TCPC (p = 0.161). Nevertheless, VVCs were a risk for the development of plastic bronchitis (PB, p < 0.001). Interventional closure of VVCs was performed in 60 (9.4%) patients at a median of 8.9 (0.6-15.1) years after TCPC, and improvement of oxygen saturation was observed in 66% of the patients. CONCLUSIONS: The prevalence of VVCs after TCPC was 15%. VVCs had no impact on survival following TCPC but were associated with a high prevalence of PB.
Journal title abbreviation:: Int J Cardiol
Year:: 2024
Journal volume:: 410
Fulltext / DOI:: doi:10.1016/j.ijcard.2024.132229
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/38838746
Print-ISSN:: 0167-5273
TUM Institution:: Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (DHM) (Prof. Hörer); Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane)2024

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (DHM) (Prof. Hörer)2024