Umeå universitets logga

umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Impact of Left Ventricular Morphology on Adverse Outcomes Following Stage 1 Palliation for Hypoplastic Left Heart Syndrome: 20 Years of National Data From Sweden
Cardiology, Pediatric Heart Centre, Skåne University Hospital, Lund, Sweden; Pediatrics, Department of Clinical Sciences, Lund University, Lund, Sweden.
Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; Children´s Heart Centre, Sahlgrenska University Hospital, Gothenburg, Sweden.
Cardiology, Pediatric Heart Centre, Skåne University Hospital, Lund, Sweden; Pediatrics, Department of Clinical Sciences, Lund University, Lund, Sweden.
Pediatrics, Department of Clinical Sciences, Lund University, Lund, Sweden; Cardiac Surgery, Pediatric Heart Centre, Skåne University Hospital, Lund, Sweden.
Visa övriga samt affilieringar
2022 (Engelska)Ingår i: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 11, nr 7, artikel-id e022929Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Hypoplastic left heart syndrome is associated with significant morbidity and mortality. We aimed to assess the influence of left ventricular morphology and choice of shunt on adverse outcome in patients with hypoplastic left heart syndrome and stage 1 palliation.

METHODS AND RESULTS: This was a retrospective analysis of patients with hypoplastic left heart syndrome with stage 1 palliation between 1999 and 2018 in Sweden. Patients (n=167) were grouped based on the anatomic subtypes aortic-mitral atresia, aortic atresia-mitral stenosis (AA-MS), and aortic-mitral stenosis. The left ventricular phenotypes including globular left ventricle (Glob-LV), miniaturized and slit-like left ventricle (LV), and the incidence of major adverse events (MAEs) including mortality were assessed. The overall mortality and MAEs were 31% and 41%, respectively. AA-MS (35%) was associated with both mortality (all other subtypes versus AA-MS: interstage-I: hazard ratio [HR], 2.7; P=0.006; overall: HR, 2.2; P=0.005) and MAEs (HR, 2.4; P=0.0009). Glob-LV (57%), noticed in all patients with AA-MS, 61% of patients with aortic stenosis-mitral stenosis, and 19% of patients with aortic atresia-mitral atresia, was associated with both mortality (all other left ventricular phenotypes versus Glob-LV: interstage-I: HR, 4.5; P=0.004; overall: HR, 3.4; P=0.0007) and MAEs (HR, 2.7; P=0.0007). There was no difference in mortality and MAEs between patients with AA-MS and without AA-MS with Glob-LV (P>0.15). Patients with AA-MS (35%) or Glob-LV (38%) palliated with a Blalock-Taussig shunt had higher overall mortality compared with those palliated with Sano shunts, irrespective of the stage 1 palliation year (AA-MS: HR, 2.6; P=0.04; Glob-LV: HR, 2.1; P=0.03).

CONCLUSIONS: Glob-LV and AA-MS are independent morphological risk factors for adverse short-and long-term outcome, especially if a Blalock-Taussig shunt is used as part of stage 1 palliation. These findings are important for the clinical management of patients with hypoplastic left heart syndrome.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2022. Vol. 11, nr 7, artikel-id e022929
Nyckelord [en]
adverse outcome, aortic atresia-mitral stenosis, globular left ventricle, hypoplastic left heart, left ventricular morphology
Nationell ämneskategori
Kardiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-194335DOI: 10.1161/JAHA.121.022929ISI: 000778262600041PubMedID: 35348003Scopus ID: 2-s2.0-85128245385OAI: oai:DiVA.org:umu-194335DiVA, id: diva2:1655928
Forskningsfinansiär
Hjärt-LungfondenTillgänglig från: 2022-05-04 Skapad: 2022-05-04 Senast uppdaterad: 2022-10-03Bibliografiskt granskad

Open Access i DiVA

fulltext(581 kB)99 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 581 kBChecksumma SHA-512
d1119ba714ff615cf531cc0d794c5bb31458141eb9146e04167c9f3ab1b4a684e1624789ae23e6c44d7a4130a8752aeafaa088e5c6e7b6909a37660c4ebd6c11
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMedScopus

Person

Rydberg, Annika

Sök vidare i DiVA

Av författaren/redaktören
Rydberg, Annika
Av organisationen
Pediatrik
I samma tidskrift
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Kardiologi

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 99 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 178 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf