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Early Outcomes of Pulmonary Valve and Right Ventricle to Pulmonary Artery (RV-PA) Conduit Replacement
e99
Abstracts
Gender should be a consideration to optimise postoperative outcomes following PVR.
SHORT ORAL PRESENTATIONS 2: THORACIC, CONGENITAL AND TRANSPLANTION
http://dx.doi.org/10.1016/j.hlc.2015.12.035
17th Nov (TUE) 13:35 - 13:40
SHORT ORAL PRESENTATIONS 2: THORACIC, CONGENITAL AND TRANSPLANTION 17th Nov (TUE) 13:30 - 13:35 Early Outcomes of Pulmonary Valve and Right Ventricle to Pulmonary Artery (RV-PA) Conduit Replacement
Long-Term Outcomes of Double Aortic Arch Division in Children: 36-Year Experience from a Single Institution Phillip Naimo *, Tyson Fricke, Julia Donald, Elie Sawan, Yves D’Udekem, Christian Brizard, Igor Konstantinov Royal Children’s Hospital, Melbourne, VIC, Australia
*
Laura Fong , Nikki Stamp, Yishay Orr, Ian Nicholson, Richard Chard Department of Cardiothoracic Surgery, Westmead Hospital, Sydney, NSW, Australia Objective: The use of transcatheter PVR is evolving however the rates of serious complications with its use are reported to be up to 21%. Outcomes for surgical PVR from the STS database reported an in-hospital mortality of 4.1% and major complication rate of 20.9%. In response, we aimed to review our experience with surgical PVR at our institution. Methods: We conducted a retrospective review of 100 patients who underwent PVR or RV-PA conduit replacement at Westmead public and private hospitals between January 2008 and April 2015. Patients with significant left heart interventions including the Ross procedure were excluded. Results: Mean age was 27 11 years and 49 patients were male. Patients’ underlying diagnoses were Tetralogy of Fallot (57%), pulmonary atresia+IVS (13%), pulmonary atresia +VSD (10%), pulmonary stenosis (13%) or other (7%). Indications for surgery included native outflow tract insufficiency (72%), conduit failure (15%), prosthetic valve failure (4%) and infective endocarditis (9%). Operations performed included PVR (16%), PVR + RVOT reconstruction (48%), PVR combined cases (5%), RV-PA conduit replacement (14%), and RV-PA conduit combined cases (17%). Mean ICU length of stay was 3 1.2 days and hospital length of stay was 8 5.6 days. 2 patients required reoperation for bleeding. There were no perioperative cerebrovascular events or 30-daymortality. Conclusion: Early outcomes with surgical PVR in adults with repaired congenital heart disease appear acceptable and comparable to reported outcomes. http://dx.doi.org/10.1016/j.hlc.2015.12.036
Purpose: Double aortic arch (DAA) is a rare anomaly which causes tracheoesophageal compression. Following repair, some patients have ongoing tracheomalacia. Longterm studies are limited. We aimed to analyse the long-term outcomes of DAA division. Methods: We retrospectively reviewed all children (n=80) who underwent surgical division of a DAA between 1978 and 2014. Surgery was performed via a median sternotomy (n=3), left thoracotomy (n=75), or right thoracotomy (n=2). Concomitant repairs (n=4) were Tetralogy of Fallot repair (n=2), patent ductus arteriosus ligation (n=1), and ventricular septal defect repair (n=1). Tracheal surgery was not performed in any of the patients. Results: Median age at repair was 1 year (range 5 days to 15.7 years). Median weight at repair was 8.7 kg (range 0.9 kg to 76 kg). There was one early death in 1987 of a patient with Noonan’s syndrome due to progressive hypertrophic cardiomyopathy. There were no late deaths. Overall survival was 98.5 1.5% (95% CI: 90.0, 99.8) at 20 years. Postoperatively, bronchoscopy identified tracheal stenosis in 2 patients, and tracheomalacia in 13 patients. There were 4 reoperations. One reoperation was due to tracheal stenosis from residual aortic arch tissue, while 3 were due to concomitant cardiac anomalies. Freedom from reoperation was 94.9 2.9 (95% CI: 85.0, 98.4) at 20 years. Follow-up was 91% (73/80) complete, with median follow-up time of 9.1 years (range 14 days to 30 years). At last follow-up, bronchoscopy identified tracheomalacia in 4 patients. Conclusion: Survival beyond hospital discharge is associated with excellent outcomes. No patient required tracheal surgery. Respiratory symptoms following DAA division are rare. http://dx.doi.org/10.1016/j.hlc.2015.12.037
Abstracts
Gender should be a consideration to optimise postoperative outcomes following PVR.
SHORT ORAL PRESENTATIONS 2: THORACIC, CONGENITAL AND TRANSPLANTION
http://dx.doi.org/10.1016/j.hlc.2015.12.035
17th Nov (TUE) 13:35 - 13:40
SHORT ORAL PRESENTATIONS 2: THORACIC, CONGENITAL AND TRANSPLANTION 17th Nov (TUE) 13:30 - 13:35 Early Outcomes of Pulmonary Valve and Right Ventricle to Pulmonary Artery (RV-PA) Conduit Replacement
Long-Term Outcomes of Double Aortic Arch Division in Children: 36-Year Experience from a Single Institution Phillip Naimo *, Tyson Fricke, Julia Donald, Elie Sawan, Yves D’Udekem, Christian Brizard, Igor Konstantinov Royal Children’s Hospital, Melbourne, VIC, Australia
*
Laura Fong , Nikki Stamp, Yishay Orr, Ian Nicholson, Richard Chard Department of Cardiothoracic Surgery, Westmead Hospital, Sydney, NSW, Australia Objective: The use of transcatheter PVR is evolving however the rates of serious complications with its use are reported to be up to 21%. Outcomes for surgical PVR from the STS database reported an in-hospital mortality of 4.1% and major complication rate of 20.9%. In response, we aimed to review our experience with surgical PVR at our institution. Methods: We conducted a retrospective review of 100 patients who underwent PVR or RV-PA conduit replacement at Westmead public and private hospitals between January 2008 and April 2015. Patients with significant left heart interventions including the Ross procedure were excluded. Results: Mean age was 27 11 years and 49 patients were male. Patients’ underlying diagnoses were Tetralogy of Fallot (57%), pulmonary atresia+IVS (13%), pulmonary atresia +VSD (10%), pulmonary stenosis (13%) or other (7%). Indications for surgery included native outflow tract insufficiency (72%), conduit failure (15%), prosthetic valve failure (4%) and infective endocarditis (9%). Operations performed included PVR (16%), PVR + RVOT reconstruction (48%), PVR combined cases (5%), RV-PA conduit replacement (14%), and RV-PA conduit combined cases (17%). Mean ICU length of stay was 3 1.2 days and hospital length of stay was 8 5.6 days. 2 patients required reoperation for bleeding. There were no perioperative cerebrovascular events or 30-daymortality. Conclusion: Early outcomes with surgical PVR in adults with repaired congenital heart disease appear acceptable and comparable to reported outcomes. http://dx.doi.org/10.1016/j.hlc.2015.12.036
Purpose: Double aortic arch (DAA) is a rare anomaly which causes tracheoesophageal compression. Following repair, some patients have ongoing tracheomalacia. Longterm studies are limited. We aimed to analyse the long-term outcomes of DAA division. Methods: We retrospectively reviewed all children (n=80) who underwent surgical division of a DAA between 1978 and 2014. Surgery was performed via a median sternotomy (n=3), left thoracotomy (n=75), or right thoracotomy (n=2). Concomitant repairs (n=4) were Tetralogy of Fallot repair (n=2), patent ductus arteriosus ligation (n=1), and ventricular septal defect repair (n=1). Tracheal surgery was not performed in any of the patients. Results: Median age at repair was 1 year (range 5 days to 15.7 years). Median weight at repair was 8.7 kg (range 0.9 kg to 76 kg). There was one early death in 1987 of a patient with Noonan’s syndrome due to progressive hypertrophic cardiomyopathy. There were no late deaths. Overall survival was 98.5 1.5% (95% CI: 90.0, 99.8) at 20 years. Postoperatively, bronchoscopy identified tracheal stenosis in 2 patients, and tracheomalacia in 13 patients. There were 4 reoperations. One reoperation was due to tracheal stenosis from residual aortic arch tissue, while 3 were due to concomitant cardiac anomalies. Freedom from reoperation was 94.9 2.9 (95% CI: 85.0, 98.4) at 20 years. Follow-up was 91% (73/80) complete, with median follow-up time of 9.1 years (range 14 days to 30 years). At last follow-up, bronchoscopy identified tracheomalacia in 4 patients. Conclusion: Survival beyond hospital discharge is associated with excellent outcomes. No patient required tracheal surgery. Respiratory symptoms following DAA division are rare. http://dx.doi.org/10.1016/j.hlc.2015.12.037