Outcomes of patients born with single-ventricle physiology and aortic arch obstruction: The 26-year Melbourne experience

摘要: Background To review the long-term outcomes of patients born with single-ventricle physiology and aortic arch obstruction. Methods Follow-up 70 consecutive neonates undergoing palliation repair, excluding hypoplastic left heart syndrome, between 1983 2008, was reviewed. Dominant anomalies were coarctation (n = 48), interrupted (n = 10), alone (n = 12). Neonatal Damus procedure repair shunt became dominant approach, being performed in 1 (10%) 10 to 1989, 9 (32%) 28 1990 1999, 23 (72%) 32 2000 2008. Results All underwent an initial at a median 6 days (range, 4-12 days): pulmonary artery banding (n = 35); Damus, (n = 33); other (n = 2). Twenty-six died before Fontan completion. Of 34 survivors banding, 17 (50%) later required 4 (12%) subaortic stenosis relief. Forty completion age 5 years 4-7 years). After mean ± after Fontan, there hospital death takedown. Overall survival similar if initially or ( P  = .3). 53% (95% confidence interval, 42%-67%). Conclusions Patients obstruction have high risk mortality first life. Their seem excellent once they reach status. It is likely that, obstruction, strategies avoid systemic outflow tract should be implemented early life, regular monitoring blood pressure warranted.