Medizinische Universität Graz - Research portal
Selected Publication:
Knez, I; Dacar, D; Mächler, H; Gamillscheg, A; Beitzke, A; Zobel, G; Rödl, S; Poier-Knez, A; Gombotz, H; Metzler, H; Rehak, P; Rigler, B.
The influence of different strategies on clinical outcome in patients undergoing total cavopulmonary connection.
Thorac Cardiovasc Surg. 1999; 47(2):101-105
Doi: 10.1055/s-2007-1013119
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- Leading authors Med Uni Graz
- Knez Igor
- Co-authors Med Uni Graz
- Beitzke Albrecht
- Dacar Drago
- Gamillscheg Andreas
- Mächler Heinrich
- Metzler Helfried
- Rehak Peter
- Rigler Bruno
- Roedl Siegfried
- Zobel Gerfried
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- Abstract:
- We report on results of a prospective clinical trial designed to demonstrate the influence of various strategies in "Total Cavopulmonary Connection" (TCPC) for palliative therapy of patients with "single ventricle" physiology. From 1989 to 1997, a total of 47 patients (mean age 4.8 +/- 3.6 years) underwent definitive TCPC at our unit. 31 patients (66%) underwent one-stage TCPC, in 16 patients (34%) we performed a two-stage modified Fontan operation; 21 patients had central fenestration (4 mm). Inhalative NO therapy in the immediate postoperative period was adopted in 1993. Overall 5-year survival was 76.4%, after two-stage TCPC 87.5%, and 81.3% in patients undergoing fenestrated procedures. Two of three patients survived perioperative Fontan take-down. We lost 11 patients (nine early and two late deaths): three patients died primarily because of neurologic dysfunction and eight patients because of cardiac failures. Under perioperative NO therapy there was no early death. After a mean follow-up of 35.9 +/- 23.3 months, 76% of all patients were in NYHA I and 21 % in NYHA I-II. 89.7% had sinus rhythm. 42% of our patients suffered from temporary pleuropericardial effusions. Definitive palliation with TCPC achieves acceptable clinical results. Two-stage repair, fenestration, and postoperative inhalative NO therapy - each have a positive influence on early and long-term survival.
- Find related publications in this database (using NLM MeSH Indexing)
- Administration, Inhalation -
- Adolescent -
- Adult -
- Cardiopulmonary Bypass -
- Child -
- Child, Preschool -
- Electrocardiography, Ambulatory -
- Female -
- Follow-Up Studies -
- Heart Bypass, Right - methods
- Heart Defects, Congenital - mortality
- Heart Defects, Congenital - physiopathology
- Heart Defects, Congenital - surgery
- Heart Ventricles - abnormalities
- Heart Ventricles - surgery
- Hospital Mortality -
- Humans -
- Infant -
- Male -
- Nitric Oxide - administration & dosage
- Nitric Oxide - therapeutic use
- Postoperative Complications - mortality
- Postoperative Complications - prevention & control
- Prospective Studies -
- Survival Rate -
- Treatment Outcome -
- Vasodilator Agents - administration & dosage
- Vasodilator Agents - therapeutic use
- Find related publications in this database (Keywords)
- Fontan Procedure
- Pulmonary Hypertension
- Inhaled Nitric Oxide
- Follow-Up