The role of bidirectional superior cavopulmonary anastomosis in the treatment of complex congenital heart defects
The role of bidirectional superior cavopulmonary anastomosis in the treatment of complex congenital heart defects
Our study was based on a group of 108 patients with complex cyanotic congenital heart defects and BCPA coming from 3 institutions. The study in unique in the number of patients with BCPA included and its results.
We have shown that the competitive sources of pulmonary blood flow following BCPA are well tolerated and they will facilitate early postoperative recovery. The BCPA can be performed safely as a primary palliation even in infants as young as 1 month of age but the postoperative course is likely to be more complicated. The postoperative growth of both pulmonary arteries will be slower in the patients undergoing the BCPA under 1 year of age when compared with the older patients. Nevertheless, the patients undergoing BCPA fall broadly into 2 subgroups. Patients with restricted pulmonary blood flow prior to BCPA will have smaller pulmonary arteries and BCPA is likely to promote their growth. In the patients with large pulmonary arteries before BCPA, lack of growth in the early follow-up may be appropriate. The competitive source of pulmonary blood flow after BCPA will mainly supply the pulmonary artery contralateral to the BCPA which may enhance its growth. The high incidence of venovenous collaterals (44%) in a smaller subgroup of patients with BCPA and competitive source of pulmonary blood flow is somewhat worrying. On the other hand, the blood provided by the competitive source will limit the extent of intrapulmonary right to left shunting following BCPA.
Our study supports the view that the BCPA is a safe primary palliative surgical procedure in selected patients with complex cyanotic congenital heart defects from early infancy (overall mortality 7.4%). The presence of a concomitant competitive source of pulmonary blood flow will provide at least medium term satisfactory palliation.
University of Southampton
1998
Slavik, Zdenek
(1998)
The role of bidirectional superior cavopulmonary anastomosis in the treatment of complex congenital heart defects.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
Our study was based on a group of 108 patients with complex cyanotic congenital heart defects and BCPA coming from 3 institutions. The study in unique in the number of patients with BCPA included and its results.
We have shown that the competitive sources of pulmonary blood flow following BCPA are well tolerated and they will facilitate early postoperative recovery. The BCPA can be performed safely as a primary palliation even in infants as young as 1 month of age but the postoperative course is likely to be more complicated. The postoperative growth of both pulmonary arteries will be slower in the patients undergoing the BCPA under 1 year of age when compared with the older patients. Nevertheless, the patients undergoing BCPA fall broadly into 2 subgroups. Patients with restricted pulmonary blood flow prior to BCPA will have smaller pulmonary arteries and BCPA is likely to promote their growth. In the patients with large pulmonary arteries before BCPA, lack of growth in the early follow-up may be appropriate. The competitive source of pulmonary blood flow after BCPA will mainly supply the pulmonary artery contralateral to the BCPA which may enhance its growth. The high incidence of venovenous collaterals (44%) in a smaller subgroup of patients with BCPA and competitive source of pulmonary blood flow is somewhat worrying. On the other hand, the blood provided by the competitive source will limit the extent of intrapulmonary right to left shunting following BCPA.
Our study supports the view that the BCPA is a safe primary palliative surgical procedure in selected patients with complex cyanotic congenital heart defects from early infancy (overall mortality 7.4%). The presence of a concomitant competitive source of pulmonary blood flow will provide at least medium term satisfactory palliation.
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Published date: 1998
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Local EPrints ID: 463133
URI: http://eprints.soton.ac.uk/id/eprint/463133
PURE UUID: 9f2a9455-855b-40d2-8f0d-5c39e6b7cfaf
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Date deposited: 04 Jul 2022 20:45
Last modified: 04 Jul 2022 20:45
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Author:
Zdenek Slavik
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