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Sociedade Brasileira de Cirurgia Cardiovascular
2018
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| Acceso en línea: | https://www.redalyc.org/articulo.oa?id=398956091011 https://www.redalyc.org/journal/3989/398956091011/ https://www.redalyc.org/journal/3989/398956091011/html/ https://www.redalyc.org/journal/3989/398956091011/398956091011.epub https://www.redalyc.org/journal/3989/398956091011/movil |
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- Late Follow-up of Patients Submitted to Total Cavopulmonary Derivation: Clinical Aspects, Reinterventions, and Complications Interfering in Morbidity and Mortality Cristiane Felix Ximenes Pessotti Paula Rodrigues Silva Machado Costa Natalia de Freitas Jatene Baranauskas Thalyta Madeira Correa Ieda Biscegli Jatene Medicina Pathology Congenital Heart Defects Fontan Procedure Heart Ventricles Objective: To identify main complications in outpatient follow-up, as well as factors before or during operation that may interfere in patient's evolution.Methods: Retrospective study of patients submitted to total cavopulmonary shunt with extracardiac conduit from 2000 to 2014 at the Hospital do Coração (São Paulo, Brazil) and who underwent clinical follow-up at this institution.Results: One hundred and fifty surgeries were performed and 59 patients maintained outpatient follow-up. The mean age of these patients at the time of surgery was 4.45 years (median of 45 months) and 70.2% of them were males. Among the patients undergoing outpatient follow-up, postoperative time at evaluation ranged from 10 days to 145 months; 30 (50.8%) patients had single left ventricle and 29 (49.2%) had single right ventricle (48.2% of these presented with hypoplastic left heart syndrome HLHS). Patients with single left ventricle had a higher percentage of reintervention-free survival, but without statistically significant difference. 40% of the patients had no complications and 35% of them presented with thrombosis at some point in the follow-up period, with ventricular dysfunction being the second most frequently found complication (15% of cases), mainly among patients with single right ventricle morphology (P=0.04). Between the patients currently under follow-up, 20 (35%) of them had been evaluated by ultrasonography and had some degree of hepatic congestion and/or hepatomegaly. 16.7% of the patients with such alteration had HLHS (P=0.057).Conclusion: Except for the right ventricular morphology, no other factor has been shown to interfere in late evolution after total cavopulmonary shunt. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398956091011 https://www.redalyc.org/journal/3989/398956091011/ https://www.redalyc.org/journal/3989/398956091011/html/ https://www.redalyc.org/journal/3989/398956091011/398956091011.epub https://www.redalyc.org/journal/3989/398956091011/movil 10.21470/1678-9741-2017-0217 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.3 Vol.33