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Surgery of single ventricles in humanitarian practice: surgery for which patients?

Published online by Cambridge University Press:  03 May 2019

Marielle Gouton ,
Olivier Michel Bical ,
Joy Zoghbi ,
Régine Roussin ,
Vincent Lucet  and
Francine Leca
Marielle Gouton*
Affiliation:
Mécénat-Chirurgie Cardiaque, Paris, France Cardiologie Congénitale, Institut Mutualiste Montsouris,Paris, France
Olivier Michel Bical
Affiliation:
Mécénat-Chirurgie Cardiaque, Paris, France
Joy Zoghbi
Affiliation:
pôle des cardiopathies congénitales, hôpital marie-lannelongue, Le Plessis-Robinson, France
Régine Roussin
Affiliation:
pôle des cardiopathies congénitales, hôpital marie-lannelongue, Le Plessis-Robinson, France
Vincent Lucet
Affiliation:
Mécénat-Chirurgie Cardiaque, Paris, France centre de cardiologie infantile, le château des côtes, Les Loges en Josas, France
Francine Leca
Affiliation:
Mécénat-Chirurgie Cardiaque, Paris, France
*
Author for correspondence: Marielle Gouton, Mécénat-Chirurgie Cardiaque, 33 rue Saint-Augustin, 75002 Paris, France. Tel: +33 1 49 24 02 02; Fax: +33 1 49 24 02 00 E-mail: m.gouton@cardiocongenitale.fr
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Abstract

Objectives:

To analyse the feasibility and effectiveness in humanitarian practice of surgical management of children with single-ventricle heart condition.

Methods:

Retrospective study of children with a single ventricle, managed by the association Mécénat-Chirurgie Cardiaque since 1996, with long-term follow-up after their return home.

Results:

Of the 138 children in our cohort, 119 had one or more surgeries (180 procedures): palliative surgery alone (systemic-pulmonary anastomosis or banding), 41; partial cavo-pulmonary connection, 47; total cavo-pulmonary connection (mean age 8.5 years), 31. Operative mortality is 5.5%. After a mean follow-up of 5.6 years, 18 children (13%) were lost to follow-up. Survival at 10 years is 79% in children receiving surgery (palliative only, 72%; partial cavo-pulmonary connection, 77%; total cavo-pulmonary connection, 97%) versus 29% in children with no surgical intervention. The prognosis is better for tricuspid atresia and double-inlet left ventricle (86 and 83% survival at 10 years) than for double-outlet right ventricle or complete atrio-ventricular canal defect (64 and 68% at 5 years).

Conclusion:

The surgery of the single ventricle in humanitarian medicine allows a very satisfactory survival after one or more surgeries tending towards a total cavo-pulmonary connection as soon as possible.

Keywords

CHDFontansingle ventricletricuspid atresia
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 5 , May 2019 , pp. 583 - 588
Copyright
© Cambridge University Press 2019 

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