Stepwise Treatment for Heterotaxy Syndrome and Functional Single Ventricle Complicated by Infra-Cardiac Total Anomalous Pulmonary Venous Connection with Ductus Venosus Stent Placement and Subsequent Occlusion.
Coil
Ductus venosus
Heterotaxy
Stent
TAPVC
Journal
Pediatric cardiology
ISSN: 1432-1971
Titre abrégé: Pediatr Cardiol
Pays: United States
ID NLM: 8003849
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
15
07
2021
accepted:
18
11
2021
pubmed:
12
1
2022
medline:
15
4
2022
entrez:
11
1
2022
Statut:
ppublish
Résumé
Even today, when the surgical outcome of congenital heart disease in the neonatal period has improved, the prognosis for heterotaxy syndrome and functional single ventricle complicated with total anomalous pulmonary venous connection (TAPVC), especially the infra-cardiac type, is catastrophic. We describe a strategy that combines percutaneous ductus venosus (DV) stent placement and occlusion after TAPVC repair to ensure survival from initial surgery to bidirectional cavopulmonary shunt (BCPS) procedure and facilitate subsequent treatment. Three consecutive patients with heterotaxy syndrome and functional single ventricle complicated by infra-cardiac TAPVC treated with our own strategy were retrospectively studied. In two infants, DV stent placement was performed on the day of birth. In one case at 11 days of age. The risk of pulmonary vein obstruction was reduced, and on-pump surgery, including TAPVC repair, was performed on a standby basis. Since the rapid increase in hepatic enzymes occurred on postoperative day 0 to 1 in all cases, percutaneous stent occlusion was performed until postoperative day 3. The procedure improved liver function. One patient died due to severe atrioventricular valve regurgitation, one case underwent BCPS, and one patient was waiting to undergo. DV stent placement can avoid TAPVC repair in the early neonatal period. After TAPVC repair, the portosystemic shunt remained, resulting in hepatic dysfunction, but this could be improved by stent and vertical vein occlusion. A series of stepwise treatments can be useful to help such critically ill infants survive the high-risk neonatal period and achieve good BCPS circulation.
Identifiants
pubmed: 35013751
doi: 10.1007/s00246-021-02782-z
pii: 10.1007/s00246-021-02782-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
756-763Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Alsoufi B, McCracken C, Schlosser B et al (2016) Outcomes of multistage palliation of infants with functional single ventricle and heterotaxy syndrome. J Thorac Cardiovasc Surg 151:1369–1377. https://doi.org/10.1016/j.jtcvs.2016.01.054
doi: 10.1016/j.jtcvs.2016.01.054
pubmed: 27085618
Khan MS, Bryant R, Kim SH et al (2015) Contemporary outcomes of surgical repair of total anomalous pulmonary venous connection in patients with heterotaxy syndrome. Ann Thorac Surg 99:2134–2140. https://doi.org/10.1016/j.athoracsur.2015.02.035
doi: 10.1016/j.athoracsur.2015.02.035
pubmed: 25912749
Foerster SR, Gauvreau K, McElhinney DB, Geva T (2008) Importance of totally anomalous pulmonary venous connection and postoperative pulmonary vein stenosis in outcomes of heterotaxy syndrome. Pediatr Cardiol 29:536–544. https://doi.org/10.1007/s00246-007-9128-5
doi: 10.1007/s00246-007-9128-5
pubmed: 18004616
Rudolph AM (2009) Congenital disease of the heart clinical-physiological considerations, 3rd edn, John Wiley and Sons, Hoboken, NJ, pp. 320–344
Lodge AJ, Rychik J, Nicolson SC et al (2004) Improving outcomes in functional single ventricle and total anomalous pulmonary venous connection. Ann Thorac surg 78:1688–1695. https://doi.org/10.1016/j.athoracsur.2004.04.057
doi: 10.1016/j.athoracsur.2004.04.057
pubmed: 15511457
Curzon CL, Milford-Beland S, Li JS et al (2008) Cardiac surgery in infants with low birth weight is associated with increased mortality: analysis of the society of thoracic surgeons congenital heart database. J Thorac Cardiovasc Surg 135:546–551. https://doi.org/10.1016/j.jtcsv.2007.09.068
doi: 10.1016/j.jtcsv.2007.09.068
pubmed: 18329467
Papamichail M, Pizanias M, Heaton N (2018) Congenital portsystemic venous shunt. Eur J Pediatr 177:285–294. https://doi.org/10.1007/s00431-017-3058-x
doi: 10.1007/s00431-017-3058-x
pubmed: 29243189
Poeppelman RS, Tobias JD (2018) Patent ductus venosus and congenital heart disease: a case report and review. Cardiol Res 9(5):330–333 https://doi.org/10.14740/cr777w
Shishido A, Hasegawa T, Kamei N et al (2020) Symptomatic portsystemic shunt via the unligated vertical vein following repair of a mixed-type total anomalous pulmonary venous conection: a case report. Ped Cardiol Carg Surg 36(3):263–268. https://doi.org/10.9794/jspccs.36.263
doi: 10.9794/jspccs.36.263
Kitano M, Yazaki S, Kagisaki K, Kurosaki K (2009) Primary palliative stenting against obstructive mixed-type total anomalous pulmonary venous connection associated with right atrial isomerism. J Interv Cardiol 22:404–409. https://doi.org/10.1111/j.1540-8183.2009.00481.x
doi: 10.1111/j.1540-8183.2009.00481.x
pubmed: 19689662
Higaki T, Yamamoto E, Nakano T et al (2010) Successful stenting of the ductus venosus in two neonates with asplenia syndrome complicated by infracardiac type total anomalous pulmonary venous connection. J Cardiol Cases 1:129–132. https://doi.org/10.1016/j.jccase.2009.10.004
doi: 10.1016/j.jccase.2009.10.004
Schwartz YM, Berkowitz D, Lorber A (1999) Transvenous coil embolization of a patent ductus venosus in a 2-month-old child. Pediatrics 103:1045–1047. https://doi.org/10.1542/peds.103.5.1045
doi: 10.1542/peds.103.5.1045
pubmed: 10224188
Lynn AM, Singh S, Congly SE et al (2016) Embolization of portosystemic shunts for treatment of medically refractory hepatic encephalopathy. Liver Transpl 22:723–731. https://doi.org/10.1002/lt.24440
doi: 10.1002/lt.24440
pubmed: 26970243
pmcid: 4917293
Stark JF, De Lebal M, Tsang VT (2006) Surgery for congenital heart defects, 3rd edn. A John Wiley and Sons, Hoboken, NJ, pp. 543–557
Nakata S, Imai Y, Takanashi Y et al (1984) A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart disease with decreased pulmonary blood flow. J Thorac Cardiovasc Surg 88:610–619
doi: 10.1016/S0022-5223(19)38300-X
Yamaki S, Tsunemoto M, Shimada M et al (1992) Quantitative analysis of pulmonary vascular disease in total anomalous pulmonary venous connection in sixty infants. J Thorac Cardiovasc Surg 104(3):728–735
doi: 10.1016/S0022-5223(19)34743-9