Vol. 19 No. 3 (2015)
CONGENITAL HEART DISEASES

Risk factors of mortality and insufficiency of cavopulmonary hemodynamics in patients after bidirectional Glen procedure

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  • N. Nichay,
  • Yu. Gorbatykh,
  • I. Soynov,
  • A. Gorbatykh,
  • A. Voitov,
  • M. Novikova,
  • S. Ivanov,
  • A. Bogachev-Prokofiyev
N. Nichay
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
Bio
Yu. Gorbatykh
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
Bio
I. Soynov
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
Bio
A. Gorbatykh
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
Bio
A. Voitov
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
Bio
M. Novikova
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
Bio
S. Ivanov
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
Bio
A. Bogachev-Prokofiyev
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
Bio
DOI: https://doi.org/10.21688/1681-3472-2015-3-26-35

Published 2015-10-22

Keywords

  • Единственный желудочек сердца,
  • Двунаправленный кавопульмональный анастомоз,
  • Факторы риска

How to Cite

Nichay, N., Gorbatykh, Y., Soynov, I., Gorbatykh, A., Voitov, A., Novikova, M., Ivanov, S., & Bogachev-Prokofiyev, A. (2015). Risk factors of mortality and insufficiency of cavopulmonary hemodynamics in patients after bidirectional Glen procedure. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 19(3), 26–35. https://doi.org/10.21688/1681-3472-2015-3-26-35

Copyright (c) 2015 Nichay N.R., Gorbatykh Yu.N., Soynov I.A., Gorbatykh A.V., Voitov A.V., Novikova M.A., Ivanov S.N., Bogachev-Prokofiyev A.V.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Objective. The study was to focus on the evaluation of in-hospital mortality, survival and risk factors of adverse outcomes in patients after bidirectional Glen procedure (BGP).
Methods. Clinical data of 130 patients who underwent BGP over a period from 2003 to 2013 were analyzed retrospectively. Patients’ age at the time of the procedure was 16 months (lower/upper quartiles 9/27 months).
Results. In-hospital mortality after BGP was 10.7%. According to the results of multivariable logistic regression analysis, the patients age, degree of atrioventricular valve (AVV) regurgitation (OR 0.79; 95% CI 0.62-0.99; р = 0.05) and duration of cardiopulmonary bypass (CPB) (OR 1.33; 95% CI 1.03-1.72; р = 0.03) were the predictors of in-hospital mortality. The 1-, 3- and 10-year survival of patients after BGP was 86.3%, 85.1% and 83.4% respectively. Freedom from adverse outcomes (mortality, removal of cavopulmonary anastomosis, unsuitable candidate for Fontan procedure) was 83.3% and 76.3% at 1- and 5-year follow-up respectively. Multivariable analysis of adverse outcome risks revealed that an increase of blood pressure in BGP (HR 1.11; 95% CI 1.00-1.22; p = 0.04), low saturation (HR 0.90; 95% CI 0.84-0.97; р<0.01) and thrombosis (HR 4.55; 95% CI 1.89-10.9; р<0.01) increased the risk of mortality and insufficiency of cavopulmonary hemodynamics in the post-operative period.
Conclusion. Younger age, high-grade AVV regurgitation and prolonged CPB increase the risk of in-hospital mortality. Low saturation, elevation of blood pressure and cavopulmonary shunt thrombosis in the post-operative period tend to be the main predictors of survival after BGP and impossibility of conversion to Fontan circulation.

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