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Younger Age at Operation Is Associated With Reinterventions After the Warden Procedure
- Source :
- The Annals of Thoracic Surgery. 111:2059-2065
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Multiple techniques are available for repair of supracardiac partial anomalous pulmonary venous return (PAPVR); however, most series fail to compare the techniques in contemporary cohorts. This study aimed to describe outcomes of the Warden procedure with a single-patch repair cohort to serve as a control.A retrospective cohort analysis of all patients at a single institution (Texas Children's Hospital, Houston, TX) included patients undergoing either the Warden procedure or single-patch repair from 1996 to 2019 for PAPVR. Reintervention was defined as any catheter or surgical procedure on the superior vena cava (SVC) or pulmonary veins. Subgroup analysis was performed within the Warden cohort to evaluate for association between an SVC patch and reintervention-free survival.In total, 158 patients (122 in the Warden group and 36 in the single-patch group) were identified. The median age at operation was younger for patients in the Warden cohort (5.4 years; interquartile range, 3.3 to 10.2 years) compared with patients in the single-patch cohort (13.3 years; interquartile range, 6.5 to 18.7 years; P.001). One patient in each cohort died. One patient required reoperation after the Warden procedure for dehiscence of the intracardiac patch. Ten patients required transcatheter reinterventions. Reintervention-free survival was not different between patients in the Warden cohort and patients in the single-patch cohort (P = .54) or within the Warden cohort in patients with an SVC patch (P = .27). When controlling for repair type, older age at repair was associated with longer reintervention-free survival (hazard ratio, 0.81; 95% confidence interval, 0.71 to 0.93; P = .002).The Warden procedure is a viable option for younger patients requiring supracardiac PAPVR repair, although these younger patients are likely at greatest risk for reintervention regardless of surgical technique.
- Subjects :
- Male
Reoperation
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Younger age
Adolescent
Partial anomalous pulmonary venous return
Subgroup analysis
030204 cardiovascular system & hematology
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Superior vena cava
Interquartile range
Humans
Medicine
Child
Retrospective Studies
business.industry
Scimitar Syndrome
Age Factors
Retrospective cohort study
Surgery
Catheter
Treatment Outcome
030228 respiratory system
Child, Preschool
Cohort
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 111
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....570cf3ae0542390d3b6d736bbc7e666a
- Full Text :
- https://doi.org/10.1016/j.athoracsur.2020.05.143