Resultados longitudinales después de la paliación de primera etapa para el síndrome del corazón izquierdo
J N Meliones1, A R Snider, E L Bove
1Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor 48109-0204.
Circulation
|November 1, 1990
Resumen
La cirugía paliativa para el síndrome del corazón izquierdo hipoplásico tenía una alta tasa de mortalidad, y la mayoría de las muertes ocurrían dentro de las 24 horas. Los sobrevivientes a largo plazo a menudo requerían procedimientos adicionales.
Área de la Ciencia:
- Cardiología Pediátrica Cardiología pediátrica.
- Cirugía del corazón congénito Cirugía del corazón congénito.
- Cuidados intensivos neonatales.
Sus antecedentes:
- El síndrome del corazón izquierdo hipoplásico (HLHS, por sus siglas en inglés) es un defecto cardíaco congénito grave que requiere una paliativa quirúrgica compleja.
- La paliación de primera etapa tiene como objetivo establecer un flujo sanguíneo sistémico y pulmonar adecuado.
Objetivo del estudio:
- Evaluar los resultados de la cirugía paliativa de primera etapa para el HLHS.
- Identificar las causas de mortalidad temprana y tardía y las complicaciones postoperatorias significativas.
Principales métodos:
- Revisión retrospectiva de 57 bebés sometidos a la primera etapa de reconstrucción HLHS.
- Análisis de la mortalidad, las complicaciones y las intervenciones posteriores.
Principales resultados:
- La supervivencia general fue del 21% (12/57).
- El 69% de las muertes ocurrieron dentro de los 30 días, con el 58% dentro de las 24 horas, principalmente debido al colapso cardiovascular.
- Las principales complicaciones incluyeron estenosis de la arteria pulmonar ramificada (23%) y derivación inadecuada (26%).
Conclusiones:
- La paliación en la primera etapa para HLHS se asocia con una alta mortalidad temprana.
- Las complicaciones postoperatorias significativas requieren intervenciones adicionales para los sobrevivientes a largo plazo.
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