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[Long-term results after the total cavopulmonary connection].
N Yoshimura1, M Yamaguchi, S Oka
1Department of Cardiothoracic Surgery, Kobe Children's Hospital, Kobe, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|April 19, 2003
Summary
This study reports on 108 patients undergoing total cavopulmonary connection (TCPC) for complex congenital heart defects. Outcomes show significant early and late mortality, with arrhythmia and desaturation being common complications.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Congenital Heart Disease
Context:
- Total cavopulmonary connection (TCPC) is a palliative surgical procedure for complex single-ventricle congenital heart defects.
- Kobe Children's Hospital performed 108 TCPC procedures between July 1988 and November 2002.
- Patient cohort included various univentricular heart conditions, tricuspid atresia, and mitral atresia.
Purpose:
- To evaluate the outcomes and complications of total cavopulmonary connection (TCPC) in a pediatric patient population.
- To analyze early and late mortality rates associated with TCPC.
- To identify common late complications following TCPC surgery.
Summary:
- 108 patients with univentricular hearts underwent TCPC, with specific high-risk modifications like fenestrated, staged, and off-pump procedures used.
- Early mortality (10 deaths) was primarily due to low cardiac output syndrome and thrombosis.
- Late mortality (5 deaths) and complications included congestive heart failure, arrhythmia, cerebral infarction, and systemic desaturation.
Impact:
- This study highlights the significant risks and long-term challenges associated with TCPC in pediatric patients with complex congenital heart disease.
- Findings underscore the need for careful patient selection, surgical technique optimization, and vigilant post-operative management.
- Understanding these outcomes can inform future surgical strategies and improve patient care for single-ventricle physiology.