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Two hundred and twenty-nine cases of bidirectional cavopulmonary anastomosis with and without antegrade pulmonary blood flow, a single-center experience

Published online by Cambridge University Press:  03 October 2024

Maksym Delikatnyi Open the ORCID record for Maksym Delikatnyi [Opens in a new window] ,
Roman Sekelyk ,
Andrii Maksymenko  and
Andrii Kurkevych Open the ORCID record for Andrii Kurkevych [Opens in a new window]
Maksym Delikatnyi*
Affiliation:
Department of Cardiac Surgery of Newborns and Early Childhood, Ukrainian Children’s Cardiac Center, Kyiv, Ukraine
Roman Sekelyk
Affiliation:
Department of Cardiac Surgery of Newborns and Early Childhood, Ukrainian Children’s Cardiac Center, Kyiv, Ukraine
Andrii Maksymenko
Affiliation:
Department of Interventional Cardiology, Ukrainian Children’s Cardiac Center, Kyiv, Ukraine
Andrii Kurkevych
Affiliation:
Department of Cardiology, Ukrainian Children’s Cardiac Center, Kyiv, Ukraine
*
Corresponding author: Maksym Delikatnyi; Email: [email protected]
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Abstract

Bidirectional cavopulmonary anastomosis is palliative surgical procedure for stepwise adaptation of the ventricle by time-phased relief of blood volume from the single functional ventricle. There still exists a controversial question regarding maintaining additional antegrade pulmonary blood flow. We retrospectively reviewed the surgical cases of 261 patients who underwent bidirectional cavopulmonary anastomosis in our institution from 2012 to 2022 with special regard to antegrade pulmonary blood flow as our preferred strategy. The mean age at the time of surgery was 33.1 months (range 2.9–192 months), and the mean weight was – 7.6 kg (range 3.9–38 kg). Furthermore, we divided all the patients into two groups: in group 1 (n = 182) – patients who underwent bidirectional cavopulmonary anastomosis with antegrade pulmonary blood flow, and in group 2 (n = 47) – patients without antegrade pulmonary blood flow. The mean follow-up time was 56 months (range 24–120 months). Mortality rate was 4.8 % (n = 11) in the past 10 years. Statistical difference between groups was in the following positions: group 2 had less ICU stay (p < 0.000125) and hospital stay (p < 0.017110); group 1 had a longer duration of pleural effusion (p < 0.000003) and amount of drainage output (p < 0.007), also demonstrated higher oxygen saturation (p < 0.000264) and Glenn shunt pressure (p < 0.002) after the surgery; but there was no difference in oxygen saturation after 6, 12, and 24 months; mortality in both groups has no statistic difference. Considering our experience, we take a stand on the controlled to antegrade pulmonary blood flow strategy during bidirectional cavopulmonary anastomosis.

Keywords

Bidirectional cavopulmonary anastomosissingle vertical physiologyantegrade pulmonary blood flow
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 9 , September 2024 , pp. 1951 - 1955
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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