Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center
Purpose The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary st...
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| Format: | Article |
| Language: | English |
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Korean Pediatric Society
2018-07-01
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| Series: | Korean Journal of Pediatrics |
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| Online Access: | http://kjp.or.kr/upload/pdf/kjp-2018-61-7-210.pdf |
| _version_ | 1818153072554147840 |
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| author | Tae Kyoung Jo Hyo Rim Suh Bo Geum Choi Jung Eun Kwon Hanna Jung Young Ok Lee Joon Yong Cho Yeo Hyang Kim |
| author_facet | Tae Kyoung Jo Hyo Rim Suh Bo Geum Choi Jung Eun Kwon Hanna Jung Young Ok Lee Joon Yong Cho Yeo Hyang Kim |
| author_sort | Tae Kyoung Jo |
| collection | DOAJ |
| description | Purpose The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. Results Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1–98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2–31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. Conclusion For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient’s condition. |
| first_indexed | 2024-12-11T14:04:48Z |
| format | Article |
| id | doaj.art-42e7255ee2e543da815cbc1264dd652a |
| institution | Directory Open Access Journal |
| issn | 1738-1061 2092-7258 |
| language | English |
| last_indexed | 2024-12-11T14:04:48Z |
| publishDate | 2018-07-01 |
| publisher | Korean Pediatric Society |
| record_format | Article |
| series | Korean Journal of Pediatrics |
| spelling | doaj.art-42e7255ee2e543da815cbc1264dd652a2022-12-22T01:03:42ZengKorean Pediatric SocietyKorean Journal of Pediatrics1738-10612092-72582018-07-0161721021610.3345/kjp.2018.61.7.21020125553451Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary centerTae Kyoung Jo0Hyo Rim Suh1Bo Geum Choi2Jung Eun Kwon3Hanna Jung4Young Ok Lee5Joon Yong Cho6Yeo Hyang Kim7 Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Daegu, Korea Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Daegu, Korea Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Daegu, Korea Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, KoreaPurpose The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. Results Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1–98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2–31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. Conclusion For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient’s condition.http://kjp.or.kr/upload/pdf/kjp-2018-61-7-210.pdfNewbornPalliative surgeryPulmonary atresiaTetralogy of Fallot |
| spellingShingle | Tae Kyoung Jo Hyo Rim Suh Bo Geum Choi Jung Eun Kwon Hanna Jung Young Ok Lee Joon Yong Cho Yeo Hyang Kim Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center Korean Journal of Pediatrics Newborn Palliative surgery Pulmonary atresia Tetralogy of Fallot |
| title | Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center |
| title_full | Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center |
| title_fullStr | Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center |
| title_full_unstemmed | Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center |
| title_short | Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center |
| title_sort | outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of fallot with severe pulmonary stenosis experience in a single tertiary center |
| topic | Newborn Palliative surgery Pulmonary atresia Tetralogy of Fallot |
| url | http://kjp.or.kr/upload/pdf/kjp-2018-61-7-210.pdf |
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