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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
5
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pubmed:dateCreated |
1991-5-31
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pubmed:abstractText |
The influence of palliation on survival was studied in 191 consecutive infants, presenting at under 1 year of age, with double-inlet ventricle (1973 to 1988, median follow-up 8.5 years). Palliative operations were performed on 154 occasions in 121 patients (63%). Survival after a systemic-pulmonary arterial shunt (n = 57) and banding of the pulmonary trunk (n = 35) was comparable (84% and 77% at 1 year, 62% and 45% at 5 years), but those who underwent repair of aortic arch obstruction fared worse (n = 18, 44% and 22% at 1 and 5 years, p less than 0.001). The remainder did not undergo an operation because of balanced physiology (n = 17, 9% of entire group), complex anatomy (n = 32, 15%), or irreversible low output (n = 19, 12%). Palliative surgery, overall, had a deleterious effect on immediate survival (greater than 1 month relative risk 6.6, p less than 0.001), but, in the survivors, medium-term outcome was improved (greater than 6 months, 0.68, p less than 0.05). This effect was most marked for those undergoing a systemic-pulmonary artery shunt (less than 1 month, 2.52; greater than 6 months, 0.43); by contrast, after banding of the pulmonary trunk, with or without additional repair of the aortic arch repair, medium-term risk was not altered (greater than 6 months, 1.13 and 0.91, respectively). These data will assist the clinician in making decisions concerning the management of infants with double-inlet ventricle and in the judicious use of palliative surgery.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:status |
MEDLINE
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pubmed:month |
May
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pubmed:issn |
0022-5223
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
101
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
917-23
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pubmed:dateRevised |
2006-11-15
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pubmed:meshHeading |
pubmed-meshheading:1708842-Anastomosis, Surgical,
pubmed-meshheading:1708842-Aortic Coarctation,
pubmed-meshheading:1708842-Heart Defects, Congenital,
pubmed-meshheading:1708842-Heart Ventricles,
pubmed-meshheading:1708842-Humans,
pubmed-meshheading:1708842-Infant,
pubmed-meshheading:1708842-Multivariate Analysis,
pubmed-meshheading:1708842-Palliative Care,
pubmed-meshheading:1708842-Pulmonary Artery,
pubmed-meshheading:1708842-Retrospective Studies,
pubmed-meshheading:1708842-Risk Factors,
pubmed-meshheading:1708842-Survival Rate
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pubmed:year |
1991
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pubmed:articleTitle |
Double-inlet ventricle presenting in infancy. II. Results of palliative operations.
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pubmed:affiliation |
Thoracic Unit, Hospital For Sick Children, London, England.
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pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
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