Comparison of definitive approaches for conotruncal defects following bidirectional Glenn procedure
Authors' conclusion
In paediatric patients with conotruncal heart defects who underwent BDG procedure, BiVC is a feasible option, especially for patients with certain Fontan risk factors, and are not ideal candidates for successful Fontan completion.
Study context
- Population
- Paediatric patients with conotruncal defects (excluding single ventricle) who underwent bidirectional Glenn (BDG) palliation, Fuwai Hospital, 2013–2022
- Participants
- 232 patients
- Exposure
- Fontan completion vs biventricular conversion after BDG
- Fontann = 142
- Biventricular conversion (BiVC)n = 90
- Outcome
- Mortality
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Postoperative mortality
- Postoperative mortality generally low and comparable
Observational data: associations, not effects.
Secondary outcomes
Median interstage period from BDG to definitive procedure
P = 0.03
- Median interstage period from BDG to definitive procedure: overall cohort median 3.83 years (IQR: 2.72-5.42)
Reintervention (any CV surgery or non-diagnostic catheterisation)
- Reintervention rate comparable between Fontan and BiVC (HR direction not stated)
- HR=1.42, 95% CI: 0.708 to 2.85, p=0.32
In-hospital outcomes (cardiopulmonary bypass, aortic cross-clamp, mechanical ventilation, ICU stay durations)
- In-hospital outcomes favoured Fontan
LV size · follow-up
- LV size smaller at baseline and within normal range at follow-up in both groups; significantly larger with BiVC at follow-up
Original publication
Comparison of definitive approaches for conotruncal defects following bidirectional Glenn procedure. Heart. Published 12 February 2024. doi:10.
Summarised from the published abstract; every number is checked against it