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Smaller right pulmonary artery is associated with longer survival time without scimitar vein repair
- Source :
- Journal of Cardiac Surgery. 36:1352-1360
- Publication Year :
- 2021
- Publisher :
- Hindawi Limited, 2021.
-
Abstract
- INTRODUCTION: The optimal management of scimitar syndrome remains incompletely defined. We (1) evaluated the impact of aortopulmonary collateral (APC) occlusion, (2) compared outcomes according to surgical approach for patients who underwent surgery, and (3) identified anatomic factors associated with longer survival time without scimitar vein repair. METHODS: We conducted a single center, retrospective study of 61 patients diagnosed with scimitar syndrome between 1995 and 2019. Right pulmonary artery to total pulmonary artery cross-sectional area (RPA:PA CSA) quantitatively assessed right pulmonary artery size. Anatomical features were analyzed for association with longer survival time without scimitar vein repair. RESULTS: Median follow-up time was 6 years (Q1-Q3, 2-12), with 96% 5-year survival. Twenty-three patients underwent APC occlusion, which significantly decreased symptoms of overcirculation (100%-46%; p = .001) and systolic pulmonary artery pressure (median, 34-29 mmHg; p = .004). Twenty-three patients underwent scimitar vein repair; 5-year freedom from scimitar vein stenosis was 90% among patients who underwent a reimplantation compared with 42% in patients with baffle repair (p = .1). Three patients underwent surgery before the first year of age, with lower 5-year freedom from scimitar vein stenosis (0% vs. 84%; p < .001). On multivariate analysis, a lower RPA:PA CSA was associated with longer survival time without scimitar vein repair (p = .003). CONCLUSIONS: APC occlusion improves the clinical status of young and hemodynamically unstable patients. Repair at an early age is associated with an increased risk of scimitar vein stenosis. Scimitar vein repair might be avoided in patients with a smaller right pulmonary artery.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Pulmonary Artery
030204 cardiovascular system & hematology
Single Center
03 medical and health sciences
0302 clinical medicine
Scimitar syndrome
medicine.artery
Occlusion
medicine
Humans
Vein
Lung
Retrospective Studies
business.industry
Scimitar Syndrome
Infant
Retrospective cohort study
respiratory system
medicine.disease
Right pulmonary artery
Surgery
Stenosis
medicine.anatomical_structure
030228 respiratory system
Pulmonary Veins
Pulmonary artery
Cardiology and Cardiovascular Medicine
business
Vascular Surgical Procedures
Subjects
Details
- ISSN :
- 15408191 and 08860440
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiac Surgery
- Accession number :
- edsair.doi.dedup.....f6203a98877ba129537e1633a103bdf7
- Full Text :
- https://doi.org/10.1111/jocs.15405