Impact of Left Ventricular Morphology on Adverse Outcomes Following Stage 1 Palliation for Hypoplastic Left Heart Syndrome: 20 Years of National Data From Sweden

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Impact of Left Ventricular Morphology on Adverse Outcomes Following Stage 1 Palliation for Hypoplastic Left Heart Syndrome: 20 Years of National Data From Sweden

Fricke, Katrin (författare): Lund University,Lunds universitet,Barnkardiologi,Forskargrupper vid Lunds universitet,Children cardiology,Lund University Research Groups,Skåne University Hospital

Mellander, Mats, 1947 (författare): Karolinska Institutet,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; Children´s Heart Centre, Sahlgrenska University Hospital, Gothenburg, Sweden

Hanséus, Katarina (författare): Lund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital

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Tran, Phan Kiet (författare): Lund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital

Johansson-Synnergren, Mats, 1968 (författare): Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; Children´s Heart Centre, Sahlgrenska University Hospital, Gothenburg, Sweden

Johansson Ramgren, Jens (författare): Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital

Rydberg, Annika (författare): Umeå University,Umeå universitet,Pediatrik

Sunnegårdh, J. (författare): Children´s Heart Centre, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrenska Academy

Dalén, M. (författare): Karolinska Institutet

Sjöberg, G. (författare): Karolinska Institutet

Weismann, Constance Gesina (författare): Lund University,Lunds universitet,Barnkardiologi,Forskargrupper vid Lunds universitet,Children cardiology,Lund University Research Groups,Skåne University Hospital

Liuba, Petru (författare): Lund University,Lunds universitet,Barnkardiologi,Forskargrupper vid Lunds universitet,Children cardiology,Lund University Research Groups,Skåne University Hospital

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John Wiley & Sons, 2022
2022
Engelska.
Ingår i: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 11:7

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

BACKGROUND: Hypoplastic left heart syndrome is associated with significant morbidity and mortality. We aimed to assess the influence of left ventricular morphology and choice of shunt on adverse outcome in patients with hypoplastic left heart syndrome and stage 1 palliation. METHODS AND RESULTS: This was a retrospective analysis of patients with hypoplastic left heart syndrome with stage 1 palliation between 1999 and 2018 in Sweden. Patients (n=167) were grouped based on the anatomic subtypes aortic-mitral atresia, aortic atresia-mitral stenosis (AA-MS), and aortic-mitral stenosis. The left ventricular phenotypes including globular left ventricle (Glob-LV), miniaturized and slit-like left ventricle (LV), and the incidence of major adverse events (MAEs) including mortality were assessed. The overall mortality and MAEs were 31% and 41%, respectively. AA-MS (35%) was associated with both mortality (all other subtypes versus AA-MS: interstage-I: hazard ratio [HR], 2.7; P=0.006; overall: HR, 2.2; P=0.005) and MAEs (HR, 2.4; P=0.0009). Glob-LV (57%), noticed in all patients with AA-MS, 61% of patients with aortic stenosis-mitral stenosis, and 19% of patients with aortic atresia-mitral atresia, was associated with both mortality (all other left ventricular phenotypes versus Glob-LV: interstage-I: HR, 4.5; P=0.004; overall: HR, 3.4; P=0.0007) and MAEs (HR, 2.7; P=0.0007). There was no difference in mortality and MAEs between patients with AA-MS and without AA-MS with Glob-LV (P>0.15). Patients with AA-MS (35%) or Glob-LV (38%) palliated with a Blalock-Taussig shunt had higher overall mortality compared with those palliated with Sano shunts, irrespective of the stage 1 palliation year (AA-MS: HR, 2.6; P=0.04; Glob-LV: HR, 2.1; P=0.03). CONCLUSIONS: Glob-LV and AA-MS are independent morphological risk factors for adverse short-and long-term outcome, especially if a Blalock-Taussig shunt is used as part of stage 1 palliation. These findings are important for the clinical management of patients with hypoplastic left heart syndrome.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

adverse outcome
aortic atresia-mitral stenosis
globular left ventricle
hypoplastic left heart
left ventricular morphology
diagnostic imaging
epidemiology
heart ventricle
human
hypoplastic left heart syndrome
mitral valve stenosis
palliative therapy
procedures
retrospective study
Sweden
treatment outcome
Heart Ventricles
Humans
Palliative Care
Retrospective Studies
adverse outcome

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Av författaren/redakt...: Fricke, Katrin; Mellander, Mats, ...; Hanséus, Katarin ...; Tran, Phan Kiet; Johansson-Synner ...; Johansson Ramgre ...; visa fler...; Rydberg, Annika; Sunnegårdh, J.; Dalén, M.; Sjöberg, G.; Weismann, Consta ...; Liuba, Petru; visa färre...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: Journal of the A ...

Av lärosätet: Göteborgs universitet; Umeå universitet; Karolinska Institutet; Lunds universitet

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