Thorac Cardiovasc Surg 2016; 64 - ePP73
DOI: 10.1055/s-0036-1571939

Patients with “Early” PCPC have a “Normal” Early Postoperative Course after TCPC

S. Georgiev 1, B. Ruf 1, G. Balling 1, J. Kasnar-Samprec 2, P. Ewert 1
  • 1Deutsches Herzzentrum München, Klinik für Kinderkardiologie und angeborene Herzfehler, München, Germany
  • 2Deutsches Herzzentrum München, Klinik für Herz- und Gefäßchirurgie, München, Germany

Objectives: Early partial cavopulmonary connection (PCPC) can be beneficial in reducing the ventricular volume overload and interstage mortality in patients with functionally univentricular hearts. One of the theoretical drawbacks is early “arrestment” of the pulmonary artery growth, which could compromise the outcome after Total cavopulmonary connection (TCPC). We aimed to investigate the early postoperative course after TCPC of patients who had undergone PCPC before the age of 3 months.

Methods: We studied all patients who received TCPC in our institution for a period of 5 years. The patients who had received “early” PCPC (defined as PCPC before the age of 90 days) were compared with the other patients in means of their preoperative characteristics and early postoperative outcomes.

Results: The study included 143 patients; 20 from them were included in the “early” PCPC group. Two patients died in the first 30 days after surgery, both from the “late” PCPC group. The patients from the “early” PCPC group had comparable preoperative characteristics with the other patients: age24 ± 7.3 versus 32 ± 30 months, p = 0.24; pulmonary artery pressure9.3 ± 2.9 versus 8.9 ± 2.3 mm Hg, p = 0.49; ventricular enddiastolic pressure 6.5 ± 3.6 versus 7.0 ± 3.1, p = 0.57. Postoperatively the patients from the “early PCPC” group did not differ from these from the “late” PCPC group in means of ventilation times (4.6 ± 1.7 vs. 6.2 + / − 6.3 hours, p = 0.24), maximal inotrope scores (13.1 ± 9.3 vs. 15 ± 9.9, p = 0.42), volume requirements in the first 24 postoperative hours (110 ± 147 vs. 109 ± 103 mL/kg, p = 0.98), length of intensive care unit stay (7 ± 6 vs. 7 ± 4 days, p = 0.67) and length of hospital stay (19 ± 11 vs. 23 ± 14 days, p = 0.22).

Conclusion: In our experience, patients with “early” PCPC do not differ in their early postoperative outcomes after TCPC from other patients after this operation. Further studies on the growth of the pulmonary arteries and the long-term outcome of these patients are needed.