- 作者：Takeshi Furukawa ; In-Sam Park ; Tadahiro Yoshikawa ; Tomomi Nishimura ; Yukihiro Takahashic ; Makoto Ando ; Naoki Wada
- 关键词：20
- 刊名：The Journal of Thoracic and Cardiovascular Surgery
- 出版年：December, 2013
- 年：2013
- 卷：146
- 期：6
- 页码：1349-1352
- 全文大小：135 K
Objective
Total cavopulmonary connection (TCPC) is rarely performed for a functional single ventricle in children with Down syndrome; therefore, the postsurgical outcomes are not well known. We evaluated mortality and related factors after TCPC in children with Down syndrome.Methods
Between January 2004 and March 2010 we identified 8 patients with Down syndrome among 235 patients who had undergone TCPC. The preoperative clinical course, preoperative data, and postoperative clinical course were evaluated. In addition, clinical parameters and postoperative clinical course were compared between children with Down syndrome (n聽=聽8) and a non-Down syndrome group (n聽=聽227).
Results
The median age at the time of TCPC was 4.1 years (range, 3.4-5.5 years), and the preoperative mean pulmonary artery pressure was 13.9聽卤聽1.81 mm Hg. We observed respiratory complications in 2 patients, surgical site infection in 3 patients, and chylothorax in 2 patients. No significant difference was observed in preoperative data and mortality rate (1 of 8 patients [12.5%] in the Down syndrome group; 5 of 227 patients [2.2%] in the non-Down syndrome group) between the groups of children with and without Down syndrome. However, when the postoperative clinical course was examined, the durations of intensive care unit stay (P聽=聽.009) and hospital stay (P聽=聽.007) were found to be significantly prolonged in the Down syndrome group.
Conclusions
Patients with Down syndrome tend to show prolonged recovery after TCPC. However, as opposed to previous reports, the mortality rate of patients undergoing TCPC is lower with no significant difference from that of children without Down syndrome.