Interventional catheterization after total cavopulmonary connection: experience in 68 patients

Area of Science:

• Cardiology
• Pediatric Surgery
• Interventional Cardiology

Background:

• Total cavopulmonary connection (TCPC) is a surgical procedure for single-ventricle physiology, enabling pulmonary blood flow.
• Interventional catheterization is crucial for managing residual defects and complications post-TCPC.

Purpose of the Study:

• To evaluate the mid-term outcomes of interventional catheterization in patients who underwent TCPC.
• To identify the types of interventions required and their success rates in this patient cohort.

Main Methods:

• Retrospective review of catheterization data from 68 patients who had TCPC between January 1995 and December 2010.
• Mid-term results assessed using angiography and/or CT scans.

Main Results:

• Sixty-nine catheterizations were performed in 53 patients; 49% required interventions.
• Common interventions included embolization of shunting vessels (28%), pulmonary artery stenting/reconnection (9%), and systemic vein stenting/recanalization (21%).
• Post-intervention oxygen saturation improved significantly (90.5% to 94.7%, P = 0.002).

Conclusions:

• 49% of patients remain in good condition post-TCPC, but many require late interventions.
• Interventions frequently address stenoses within the TCPC or right-to-left shunts.
• A multicenter program is recommended to identify patients at risk for complications.