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We compared intensive care unit (ICU) and overall length of stay (LOS), chest tube (CT) duration, days of mechanical ventilation and mortality for non-fenestrated, extracardiac Fontans (NFEF) performed on and off cardiopulmonary bypass (CBP).
A retrospective review identified 135 patients who underwent NFEF between January 2004 and March 2012. Patients were excluded if they required intracardiac repair which requires CBP. Outcomes were analyzed by adjusted multiple linear regression and propensity score weighted regression to reduce bias.
Of the 135 pts, 47 had hypoplastic left heart syndrome, 25 had tricuspid atresia, 16 had atrioventricular septal defect, 15 had double outlet right ventricle, 14 had double inlet left ventricle, 10 had pulmonary atresia with intact ventricular septum, 4 had l-transposition of the great arteries, 2 had d-transposition of the great arteries, and 2 had critical aortic stenosis. CBP was used in 30 patients and avoided in 105 patients. A comparison of adjusted linear regression and propensity score weighted regression results for overall LOS, ICU LOS, days of mechanical ventilation, and CT days is presented in Table 1. Mortality was low in both groups (CBP: 0.07 + 0.05; Off-CBP: 0.01 + 0.01, p =0.06).
The off pump NFEF is associated with significant decreases in ICU and total LOS and in days of mechanical ventilation. Whether this reduction justifies additional surgeries to limit CBP remains unclear.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Congenital Cardiology Solutions: Congenital Heart Surgery
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1205M-139
- 2013 American College of Cardiology Foundation