학술논문

Preoperative B-type natriuretic peptide levels are associated with outcome after total cavopulmonary connection (Fontan)
Document Type
article
Source
Journal of Thoracic and Cardiovascular Surgery. 148(1)
Subject
Biomedical and Clinical Sciences
Cardiovascular Medicine and Haematology
Clinical Sciences
Heart Disease
Clinical Research
Patient Safety
Brain Disorders
Cardiovascular
Biomarkers
Child
Child
Preschool
Female
Fontan Procedure
Heart Defects
Congenital
Humans
Male
Natriuretic Peptide
Brain
Palliative Care
Postoperative Complications
Prospective Studies
Reoperation
Risk Factors
Time Factors
Treatment Outcome
Cardiorespiratory Medicine and Haematology
Respiratory System
Cardiovascular medicine and haematology
Clinical sciences
Language
Abstract
ObjectiveThe study objective was to determine the association between preoperative B-type natriuretic peptide levels and outcome after total cavopulmonary connection. Surgical palliation of univentricular cardiac defects requires a series of staged operations, ending in a total cavopulmonary connection. Although outcomes have improved, there remains an unpredictable risk of early total cavopulmonary connection takedown. The prediction of adverse postoperative outcomes is imprecise, despite an extensive preoperative evaluation.MethodsWe prospectively enrolled 50 patients undergoing total cavopulmonary connection. We collected preoperative clinical data, preoperative plasma B-type natriuretic peptide levels, and postoperative outcomes, including the incidence of an adverse outcome within 1 year of surgery (defined as death, total cavopulmonary connection takedown, or the need for cardiac transplantation).ResultsThe mean age of patients was 4.7 years (standard deviation, 2.1 years). The median (interquartile range) preoperative B-type natriuretic peptide levels were higher in patients who required total cavopulmonary connection takedown and early postoperative mechanical cardiac support (n = 3; median, 55; interquartile range, 42-121) compared with those with a good outcome (n = 47; median, 11; interquartile range, 5-17) (P