ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The effects of leaving additional pulmonary blood flow in combination with bidirectional cavopulmonary anastomosis on early outcomes
Hüsnü Fırat Altın1, Ali Rıza Karacı2, Numan Ali Aydemir2
1Departments of Pediatric Cardiovascular Surgery, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Departments of Pediatric Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.10351
Background: This study aims to assess the effects of additional pulmonary blood flow on the early outcomes of patients who underwent bidirectional cavopulmonary anastomosis due to single ventricle physiology.

Methods: A total of 121 patients (62 males, 59 females; mean age 45.2±41.1 months; median age 31 months; range 4-252 months) who underwent bidirectional cavopulmonary anastomosis between January 2004 and July 2010 were retrospectively analyzed. Patients were divided into two groups as having (group 1) or not having (group 2) additional pulmonary blood flow accompanied by bidirectional cavopulmonary anastomosis. There was no demographic difference between the groups.

Results: While mortality was seen in three patients (3.4%) in group 1, there was none (0%) in group 2 (p=0.55). Mean postoperative oxygen saturation value was 87.1±5.8 in group 1 and 83.4±6.1 in group 2 (p=0.01). Mean duration of intensive care stay was 3±5.4 days (median 2.0 days) in group 1 and 3.3±2.2 days (median 3.0 days) in group 2 (p=0.02). Mean duration of hospital stay was 9.2±7.3 days (median 7.0 days) in group 1 and 11.6±7.8 days (median 8.0 days) in group 2, with a statistically significant difference between the groups (p=0.03).

Conclusion: Oxygen saturation values are higher and durations of intensive care and hospital stay are shorter in patients with additional pulmonary blood flow in early postoperative period. Maintenance of antegrade pulmonary blood flow in patients with pulmonary arterial pressure at ≤16 mmHg who underwent bidirectional cavopulmonary anastomosis provides an improved postoperative clinical course.

Keywords : Bidirectional cavopulmonary anastomosis; palliation; pulmonary blood flow; single ventricle physiology
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