Association of Lymphatic Abnormalities with Early Complications after Fontan Operation.
Child, Preschool
Cross-Sectional Studies
Databases, Factual
Female
Fontan Procedure
/ adverse effects
Heart Defects, Congenital
/ complications
Hemodynamics
Humans
Lymphatic Abnormalities
/ complications
Lymphatic System
/ abnormalities
Magnetic Resonance Imaging
Male
Postoperative Complications
/ diagnostic imaging
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Journal
The Thoracic and cardiovascular surgeon
ISSN: 1439-1902
Titre abrégé: Thorac Cardiovasc Surg
Pays: Germany
ID NLM: 7903387
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
pubmed:
1
1
2021
medline:
29
4
2021
entrez:
31
12
2020
Statut:
ppublish
Résumé
Increased central venous pressure is inherent in Fontan circulation but not strongly related to Fontan complication. Abnormalities of the lymphatic circulation may play a crucial role in early Fontan complications. This was a retrospective, single-center study of patients undergoing Fontan operation from 2008 to 2015. The primary outcome was significant early Fontan complication defined as secondary in-hospital treatment due to peripheral edema, ascites, pleural effusions, protein-losing enteropathy, or plastic bronchitis. All patients received T2-weighted magnetic resonance images to assess abdominal and thoracic lymphatic perfusion pattern 6 months after Fontan completion with respect to localization, distribution, and extension of lymphatic perfusion pattern (type 1-4) and with application of an area score (0-12 points). Nine out of 42 patients developed early Fontan complication. Patients with complication had longer chest tube drainage (mean 28 [interquartile range [IQR]: 13-60] vs. 13 [IQR: 2-22] days, Early Fontan complication is related to hemodynamic factors such as circuit obstruction and to the occurrence and extent of lymphatic congestion.
Sections du résumé
BACKGROUND
Increased central venous pressure is inherent in Fontan circulation but not strongly related to Fontan complication. Abnormalities of the lymphatic circulation may play a crucial role in early Fontan complications.
METHODS
This was a retrospective, single-center study of patients undergoing Fontan operation from 2008 to 2015. The primary outcome was significant early Fontan complication defined as secondary in-hospital treatment due to peripheral edema, ascites, pleural effusions, protein-losing enteropathy, or plastic bronchitis. All patients received T2-weighted magnetic resonance images to assess abdominal and thoracic lymphatic perfusion pattern 6 months after Fontan completion with respect to localization, distribution, and extension of lymphatic perfusion pattern (type 1-4) and with application of an area score (0-12 points).
RESULTS
Nine out of 42 patients developed early Fontan complication. Patients with complication had longer chest tube drainage (mean 28 [interquartile range [IQR]: 13-60] vs. 13 [IQR: 2-22] days,
CONCLUSION
Early Fontan complication is related to hemodynamic factors such as circuit obstruction and to the occurrence and extent of lymphatic congestion.
Identifiants
pubmed: 33383591
doi: 10.1055/s-0040-1722178
pmc: PMC7909602
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1-e9Informations de copyright
The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Déclaration de conflit d'intérêts
None declared.
Références
J Thorac Cardiovasc Surg. 1996 Sep;112(3):672-80
pubmed: 8800155
J Am Heart Assoc. 2020 Apr 7;9(7):e015318
pubmed: 32223393
Radiology. 2019 Jun;291(3):774-780
pubmed: 30938628
Congenit Heart Dis. 2007 Sep-Oct;2(5):288-300
pubmed: 18377444
J Pediatr. 2015 Aug;167(2):331-7
pubmed: 26009017
Congenit Heart Dis. 2016 May;11(3):270-5
pubmed: 26554755
Heart. 2016 Jul 15;102(14):1115-9
pubmed: 27033590
Congenit Heart Dis. 2008 Jul-Aug;3(4):269-76
pubmed: 18715461
Congenit Heart Dis. 2016 Jul;11(4):296-308
pubmed: 27226033
Ann Thorac Surg. 2013 Apr;95(4):1409-16
pubmed: 23453748
J Thorac Cardiovasc Surg. 1977 Mar;73(3):436-42
pubmed: 65500
Cardiol Young. 2020 May;30(5):641-648
pubmed: 32248856
World J Pediatr Congenit Heart Surg. 2020 Jan;11(1):92-96
pubmed: 31835975
World J Pediatr Congenit Heart Surg. 2017 Nov;8(6):672-682
pubmed: 29187105
J Am Heart Assoc. 2020 Mar 17;9(6):e014172
pubmed: 32172648
J Clin Anesth. 1992 Jan-Feb;4(1):4-10
pubmed: 1540367
Heart. 2016 Jul 15;102(14):1081-6
pubmed: 27220691
J Thorac Cardiovasc Surg. 1998 May;115(5):1063-73
pubmed: 9605076
Pediatr Cardiol. 2008 Jul;29(4):771-4
pubmed: 18188635
Cardiol Young. 2011 Aug;21(4):363-77
pubmed: 21349233
J Thorac Cardiovasc Surg. 1984 Oct;88(4):610-9
pubmed: 6482493
Circ Res. 2016 Feb 5;118(3):515-30
pubmed: 26846644
Circulation. 2019 Jul 1;:CIR0000000000000696
pubmed: 31256636
J Am Coll Cardiol. 2014 Jul 8;64(1):54-62
pubmed: 24998129
Rofo. 2015 Dec;187(12):1099-107
pubmed: 26327669
Cardiol Young. 2020 May;30(5):698-709
pubmed: 32364090