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Systemic venous collateral development after the bidirectional cavopulmonary anastomosis. Prevalence and predictors
A G Magee1, B W McCrindle, J Mawson
1Department of Pediatrics, The Hospital for Sick Children and the University of Toronto Faculty of Medicine, Canada.
Journal of the American College of Cardiology
|August 26, 1998
Summary
Systemic venous collaterals are common after bidirectional cavopulmonary anastomosis. Their development is linked to a pressure gradient between the superior vena cava and right atrium post-surgery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Thoracic Surgery
Background:
- Systemic venous collaterals are a known complication following cavopulmonary anastomosis.
- Understanding their development is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of systemic venous collaterals after bidirectional cavopulmonary anastomosis.
- To identify factors associated with the development of these collaterals.
Main Methods:
- Cardiac catheterization was performed in 103 patients.
- Measurements were taken before and after bidirectional cavopulmonary anastomosis.
Main Results:
- 31% of patients (32 of 103) developed venous collaterals post-surgery.
- Collateral development was associated with abnormal superior vena cava connection, pulmonary artery distortion, and altered venous pressures.
- A significant pressure gradient between the superior vena cava and right atrium was the only independent predictor (OR 1.33 per mm Hg, p=0.001).
Conclusions:
- Systemic venous collaterals are frequent after bidirectional cavopulmonary anastomosis.
- Their presence is associated with a significant postoperative pressure gradient between the superior vena cava and right atrium.