Bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow. Retrospective multicenter experience
Abstract Background Although pulmonary artery banding (PAB) has been generally acknowledged as an initial palliative treatment for patients having single ventricle (SV) physiology and unrestrictive pulmonary blood flow (UPBF), it may result in unfavorable outcomes. Performing bidirectional Glenn (BD...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-024-02572-7 |
| _version_ | 1797273345189740544 |
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| author | Gaser A. Abdelmohsen Hala A. Gabel Rawan M. Alamri Ahmed Baamer Osman O. Al-Radi Aliaa Binyamin Ahmed A. Jamjoom Ahmed F. Elmahrouk Saud A. Bahaidarah Naif A. Alkhushi Mohamed H. Abdelsalam Hossam Ibrahim Ahmed R. Elakaby Adeep Khawaji Abdullah Alghobaishi Khadijah A. Maghrabi Zaher F. Zaher Jameel A. Al-Ata Ahmad S. Azhar Ahmed M. Dohain |
| author_facet | Gaser A. Abdelmohsen Hala A. Gabel Rawan M. Alamri Ahmed Baamer Osman O. Al-Radi Aliaa Binyamin Ahmed A. Jamjoom Ahmed F. Elmahrouk Saud A. Bahaidarah Naif A. Alkhushi Mohamed H. Abdelsalam Hossam Ibrahim Ahmed R. Elakaby Adeep Khawaji Abdullah Alghobaishi Khadijah A. Maghrabi Zaher F. Zaher Jameel A. Al-Ata Ahmad S. Azhar Ahmed M. Dohain |
| author_sort | Gaser A. Abdelmohsen |
| collection | DOAJ |
| description | Abstract Background Although pulmonary artery banding (PAB) has been generally acknowledged as an initial palliative treatment for patients having single ventricle (SV) physiology and unrestrictive pulmonary blood flow (UPBF), it may result in unfavorable outcomes. Performing bidirectional Glenn (BDG) surgery without initial PAB in some selected cases may avoid the complications associated with PAB and reduce the number of operative procedures for these patients. This research aimed to assess the outcome of BDG surgery performed directly without doing initial PAB in patients with SV-UPBF. Methods This Multicenter retrospective cohort includes all patients with SV-UPBF who had BDG surgery. Patients were separated into two groups. Patients in Group 1 included patients who survived till they received BDG (20 Patients) after initial PAB (28 patients), whereas patients in Group 2 got direct BDG surgery without first performing PAB (16 patients). Cardiac catheterization was done for all patients before BDG surgery. Patients with indexed pulmonary vascular resistance (PVRi) ≥ 5 WU.m2 at baseline or > 3 WU.m2 after vasoreactivity testing were excluded. Results Compared with patients who had direct BDG surgery, PAB patients had a higher cumulative mortality rate (32% vs. 0%, P = 0.016), with eight deaths after PAB and one mortality after BDG. There were no statistically significant differences between the patient groups who underwent BDG surgery regarding pulmonary vascular resistance, pulmonary artery pressure, postoperative usage of sildenafil or nitric oxide, intensive care unit stay, or hospital stay after BDG surgery. However, the cumulative durations in the intensive care unit (ICU) and hospital were more prolonged in patients with BDG after PAB (P = 0.003, P = 0.001respectively). Conclusion Direct BDG surgery without the first PAB is related to improved survival and shorter hospital stays in some selected SV-UPBF patients. |
| first_indexed | 2024-03-07T14:42:01Z |
| format | Article |
| id | doaj.art-b6a1859ee2694a929332d7347a335763 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-07T14:42:01Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-b6a1859ee2694a929332d7347a3357632024-03-05T20:18:38ZengBMCJournal of Cardiothoracic Surgery1749-80902024-02-011911910.1186/s13019-024-02572-7Bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow. Retrospective multicenter experienceGaser A. Abdelmohsen0Hala A. Gabel1Rawan M. Alamri2Ahmed Baamer3Osman O. Al-Radi4Aliaa Binyamin5Ahmed A. Jamjoom6Ahmed F. Elmahrouk7Saud A. Bahaidarah8Naif A. Alkhushi9Mohamed H. Abdelsalam10Hossam Ibrahim11Ahmed R. Elakaby12Adeep Khawaji13Abdullah Alghobaishi14Khadijah A. Maghrabi15Zaher F. Zaher16Jameel A. Al-Ata17Ahmad S. Azhar18Ahmed M. Dohain19Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityCardiac Surgery Division, Department of Surgery, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityCardiac Surgery Division, Department of Surgery, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityDivision of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research CenterDivision of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research CenterPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityDepartment of Pediatrics, King Fahad Armed Forces HospitalDepartment of Pediatrics, King Fahad Armed Forces HospitalPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityPediatric Cardiology Division, Department of Pediatrics, King Abdulaziz UniversityAbstract Background Although pulmonary artery banding (PAB) has been generally acknowledged as an initial palliative treatment for patients having single ventricle (SV) physiology and unrestrictive pulmonary blood flow (UPBF), it may result in unfavorable outcomes. Performing bidirectional Glenn (BDG) surgery without initial PAB in some selected cases may avoid the complications associated with PAB and reduce the number of operative procedures for these patients. This research aimed to assess the outcome of BDG surgery performed directly without doing initial PAB in patients with SV-UPBF. Methods This Multicenter retrospective cohort includes all patients with SV-UPBF who had BDG surgery. Patients were separated into two groups. Patients in Group 1 included patients who survived till they received BDG (20 Patients) after initial PAB (28 patients), whereas patients in Group 2 got direct BDG surgery without first performing PAB (16 patients). Cardiac catheterization was done for all patients before BDG surgery. Patients with indexed pulmonary vascular resistance (PVRi) ≥ 5 WU.m2 at baseline or > 3 WU.m2 after vasoreactivity testing were excluded. Results Compared with patients who had direct BDG surgery, PAB patients had a higher cumulative mortality rate (32% vs. 0%, P = 0.016), with eight deaths after PAB and one mortality after BDG. There were no statistically significant differences between the patient groups who underwent BDG surgery regarding pulmonary vascular resistance, pulmonary artery pressure, postoperative usage of sildenafil or nitric oxide, intensive care unit stay, or hospital stay after BDG surgery. However, the cumulative durations in the intensive care unit (ICU) and hospital were more prolonged in patients with BDG after PAB (P = 0.003, P = 0.001respectively). Conclusion Direct BDG surgery without the first PAB is related to improved survival and shorter hospital stays in some selected SV-UPBF patients.https://doi.org/10.1186/s13019-024-02572-7Single ventricleUnrestrictive pulmonary flowPulmonary artery bandingBidirectional Glenn |
| spellingShingle | Gaser A. Abdelmohsen Hala A. Gabel Rawan M. Alamri Ahmed Baamer Osman O. Al-Radi Aliaa Binyamin Ahmed A. Jamjoom Ahmed F. Elmahrouk Saud A. Bahaidarah Naif A. Alkhushi Mohamed H. Abdelsalam Hossam Ibrahim Ahmed R. Elakaby Adeep Khawaji Abdullah Alghobaishi Khadijah A. Maghrabi Zaher F. Zaher Jameel A. Al-Ata Ahmad S. Azhar Ahmed M. Dohain Bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow. Retrospective multicenter experience Journal of Cardiothoracic Surgery Single ventricle Unrestrictive pulmonary flow Pulmonary artery banding Bidirectional Glenn |
| title | Bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow. Retrospective multicenter experience |
| title_full | Bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow. Retrospective multicenter experience |
| title_fullStr | Bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow. Retrospective multicenter experience |
| title_full_unstemmed | Bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow. Retrospective multicenter experience |
| title_short | Bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow. Retrospective multicenter experience |
| title_sort | bidirectional glenn surgery without palliative pulmonary artery banding in univentricular heart with unrestricted pulmonary flow retrospective multicenter experience |
| topic | Single ventricle Unrestrictive pulmonary flow Pulmonary artery banding Bidirectional Glenn |
| url | https://doi.org/10.1186/s13019-024-02572-7 |
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