Pulmonary flow study predicts survival in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries Jiaquan Zhu,

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Presentation transcript:

Pulmonary flow study predicts survival in pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries Jiaquan Zhu, MD, PhD, James Meza, MD, Atsuko Kato, MD, Arezou Saedi, MD, Devin Chetan, MD, Rachel Parker, BScH, Christopher A. Caldarone, MD, Brian W. McCrindle, MD, MPH, Glen S. Van Arsdell, MD, Osami Honjo, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 152, Issue 6, Pages 1494-1503.e1 (December 2016) DOI: 10.1016/j.jtcvs.2016.07.082 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Flowchart of surgical strategy. The number in the bracket represents number of deaths. PA, Pulmonary atresia; VSD, ventricular septal defect; MAPCAs, major aortopulmonary collateral arteries. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 1494-1503.e1DOI: (10.1016/j.jtcvs.2016.07.082) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Relationship between ventricular septal defect (VSD) status and mean pulmonary artery pressure (PAP) (n = 40) (A) and total neo-pulmonary artery index (TNPAI) (n = 38) (B). The Journal of Thoracic and Cardiovascular Surgery 2016 152, 1494-1503.e1DOI: (10.1016/j.jtcvs.2016.07.082) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Overall survival (A) and survival stratified by mean pulmonary artery pressure (PAP) on the flow study (B). The Journal of Thoracic and Cardiovascular Surgery 2016 152, 1494-1503.e1DOI: (10.1016/j.jtcvs.2016.07.082) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Histogram demonstrating distribution of mean pulmonary artery pressure (PAP) on the flow study and death at any point during the study. VSD, Ventricular septal defect. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 1494-1503.e1DOI: (10.1016/j.jtcvs.2016.07.082) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Correlation between the latest right ventricular systolic pressure/left ventricular systolic pressure (RVSP/LVSP) ratio and mean pulmonary artery pressure (PAP) on the flow study (A) or baseline total neo-pulmonary artery index (TNPAI) (B) (n = 17). The Journal of Thoracic and Cardiovascular Surgery 2016 152, 1494-1503.e1DOI: (10.1016/j.jtcvs.2016.07.082) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

A high mean PAP (≥25 mm Hg) on a flow study is associated with poor medium-term survival. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 1494-1503.e1DOI: (10.1016/j.jtcvs.2016.07.082) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

The Journal of Thoracic and Cardiovascular Surgery 2016 152, 1494-1503 The Journal of Thoracic and Cardiovascular Surgery 2016 152, 1494-1503.e1DOI: (10.1016/j.jtcvs.2016.07.082) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions