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A Preclinical Model of Orthotopic Heart Transplantation in Bama Miniature Pigs Using Biatrial Technique
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Systemic Venous Reconstructions During Pediatric Heart Transplantation.

Firat Altin1, Bahaaldin Alsoufi2, Kirk Kanter3

  • 1Department of Pediatric Cardiac Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Training and Research Hospital, Istanbul, Turkey.

World Journal for Pediatric & Congenital Heart Surgery
|October 1, 2021
PubMed
Summary
This summary is machine-generated.

Systemic venous reconstruction is common in pediatric heart transplantation (HT) for congenital heart disease. Post-transplant stenosis and interventions are frequent, especially in patients with prior Glenn anastomosis, suggesting a need to refine surgical techniques.

Keywords:
autograftcavopulmonary anastomosiscongenital heart diseasecongenital heart surgeryheart transplantationtotal cavopulmonary connection

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Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Transplantation Medicine

Background:

  • Congenital heart disease (CHD) is a primary reason for pediatric heart transplantation (HT).
  • Systemic venous anomalies frequently complicate CHD, necessitating complex surgical reconstruction during HT.
  • Limited documentation exists on the techniques and outcomes of venous reconstruction in pediatric HT.

Purpose of the Study:

  • To evaluate the incidence and outcomes of systemic venous reconstruction in pediatric heart transplantation.
  • To identify risk factors for post-transplant venous complications.
  • To assess the need for interventions following venous reconstruction in this population.

Main Methods:

  • Retrospective descriptive study of pediatric heart transplant recipients at Emory University (2006-2017).
  • Analysis of surgical data, follow-up records, and interventions for patients requiring systemic venous reconstruction.
  • Comparison of outcomes based on prior surgical history, including Glenn anastomosis and Fontan procedure.

Main Results:

  • 41% of 179 pediatric heart transplants required systemic venous reconstruction.
  • Systemic venous stenosis occurred in 18.9% of these patients, with 10.8% needing interventions.
  • Prior bilateral Glenn anastomosis was associated with a high risk of stenosis and interventions.
  • Patients without prior Glenn or Fontan procedures had fewer systemic venous complications.

Conclusions:

  • Systemic venous reconstruction is frequently required in pediatric heart transplantation for CHD.
  • Post-transplant stenosis and the need for interventions are relatively common complications.
  • Current surgical techniques for venous reconstruction in complex CHD patients may require optimization to improve outcomes.