Mid-term results of the Lugones procedure for scimitar syndrome repair.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lugones Ignacio, Gonzalez Calle Antonio, Pérez-Caballero Ramón, Pelella Giuseppe, Fouilloux Virginie, Martínez Inés A, Laudani Veronica, Katewa Ashish, Díliz-Nava Héctor S, López Terrazas Javier H, Palacios Macedo-Quenot Alexis J, Gil-Jaurena Juan Miguel, Klinger Daniel A, Chiostri Benjamin, Rosso Andrés, Berber Norberto, De Los Santos María Sol, Troncoso Natalia, Zerpa Pacheco Victoria E, Biancolini Fernanda, Biancolini Julio, Rancati Julieta, Jorajuria Alejandro, Balaji Ayush, Graneros Héctor, Juaneda Ignacio, Kreutzer Christian, St Louis James D
Аннотация
METHODS: We performed a multicenter retrospective descriptive study of patients undergoing scimitar syndrome repair with the Lugones procedure. Three variants were used: original, variant A with atrial septum repositioning, and variant B with an interatrial pericardial flap. Primary end points were survival, freedom from reoperation, and freedom from pulmonary venous obstruction. Follow-up was based on clinical assessment and serial echocardiography; computed tomography scan, magnetic resonance imaging/4-dimensional flow magnetic resonance imaging, or cardiac catheterization was obtained when echocardiographic assessment was limited, clinical or imaging findings were equivocal, or complementary anatomic/hemodynamic information was sought.
RESULTS: Thirty-eight patients from 11 institutions were included (median age, 5 years; range, 0.7-43). Preoperative scimitar vein stenosis was present in approximately 29%; aortopulmonary collaterals were embolized preoperatively in 24 patients (63%). The original procedure was performed in 28 cases, variant A in 5 cases, and variant B in 5 cases. In-hospital mortality was 0%. Early complications were uncommon (1 postoperative pulmonary venous pathway obstruction due to extrinsic compression; 1 transient diaphragmatic dysfunction). Mean follow-up was 74 months (maximum 13.5 years), with no late deaths, reoperations, recurrent obstruction, or additional late pulmonary venous pathway obstruction. Computed tomography scans consistently demonstrated wide reconstructed pathways; 4-dimensional flow magnetic resonance imaging showed physiological pulmonary venous flow patterns after repair.
CONCLUSIONS: The Lugones procedure yielded excellent mid-term outcomes with no deaths or reoperations and a very low incidence of postoperative pulmonary venous obstruction.