Anterograde blood flow associated with modified Blalock-Taussig shunt does not modify pulmonary artery growth compared with modified Blalock-Taussig shunt alone.


Journal

Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 29 07 2020
revised: 08 11 2020
accepted: 12 11 2020
pubmed: 30 1 2021
medline: 2 6 2021
entrez: 29 1 2021
Statut: ppublish

Résumé

The main difference between extreme tetralogy of Fallot (TOF) and pulmonary atresia with ventricle septal defect (PA/VSD) is anterograde pulmonary blood flow (APBF). It is speculated that the association of modified Blalock-Taussig shunt (mBTS) with APBF favours shunt thrombosis, but promotes better pulmonary artery growth. To compare pulmonary artery growth after mBTS between TOF and PA/VSD. From 1995 to 2018, 77 mBTS procedures were performed in infants (aged<1 year): 45 for TOF; 32 for PA/VSD. Using a 1/1 propensity score-matched analysis, 38 patients were included (19 per group). Delta Nakata was defined as the difference in the Nakata index before biventricular repair and before mBTS. After matching, the preoperative Nakata index was similar in the two groups (TOF 101±34 vs. PA/VSD 106±35 mm We found no difference in pulmonary artery growth between APBF with mBTS versus mBTS alone. Thus, we could not show an increase in mBTS thrombosis with APBF.

Sections du résumé

BACKGROUND BACKGROUND
The main difference between extreme tetralogy of Fallot (TOF) and pulmonary atresia with ventricle septal defect (PA/VSD) is anterograde pulmonary blood flow (APBF). It is speculated that the association of modified Blalock-Taussig shunt (mBTS) with APBF favours shunt thrombosis, but promotes better pulmonary artery growth.
AIM OBJECTIVE
To compare pulmonary artery growth after mBTS between TOF and PA/VSD.
METHODS METHODS
From 1995 to 2018, 77 mBTS procedures were performed in infants (aged<1 year): 45 for TOF; 32 for PA/VSD. Using a 1/1 propensity score-matched analysis, 38 patients were included (19 per group). Delta Nakata was defined as the difference in the Nakata index before biventricular repair and before mBTS.
RESULTS RESULTS
After matching, the preoperative Nakata index was similar in the two groups (TOF 101±34 vs. PA/VSD 106±35 mm
CONCLUSIONS CONCLUSIONS
We found no difference in pulmonary artery growth between APBF with mBTS versus mBTS alone. Thus, we could not show an increase in mBTS thrombosis with APBF.

Identifiants

pubmed: 33509744
pii: S1875-2136(21)00011-5
doi: 10.1016/j.acvd.2020.11.007
pii:
doi:

Types de publication

Comparative Study Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

268-276

Informations de copyright

Copyright © 2021 Elsevier Masson SAS. All rights reserved.

Auteurs

Marien Lenoir (M)

Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France. Electronic address: lenoirmarien@gmail.com.

Beatrice Desnous (B)

Department of paediatric neurology, Timone hospital, AP-HM, 13005 Marseille, France.

Bilal Rahmani (B)

Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.

Nabila El Gueddari (N)

Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.

Édouard Aries (É)

Department of paediatric cardiology, Timone hospital, AP-HM, 13385 Marseille, France.

Fedoua El Louali (F)

Department of paediatric cardiology, Timone hospital, AP-HM, 13385 Marseille, France.

Philippe Aldebert (P)

Department of paediatric cardiology, Timone hospital, AP-HM, 13385 Marseille, France.

Caroline Ovaert (C)

Department of paediatric cardiology, Timone hospital, AP-HM, 13385 Marseille, France.

Dominique Metras (D)

Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.

Loic Macé (L)

Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.

Virginie Fouilloux (V)

Department of paediatric cardiac surgery, Timone hospital, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.

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