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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMANUEL, Valdano
dc.contributor.authorMORAIS, Humberto
dc.contributor.authorTURQUETTO, Aida L. R.
dc.contributor.authorMIGUEL, Gade
dc.contributor.authorMIANA, Leonardo A.
dc.contributor.authorPEDRO, Albino
dc.contributor.authorNUNES, Maria A. S.
dc.contributor.authorLEON, Gilberto
dc.contributor.authorMAGALHAES, Manuel Pedro
dc.contributor.authorMARTINS, Telmo
dc.contributor.authorJUNIOR, Antonio P. F.
dc.identifier.citationWORLD JOURNAL FOR PEDIATRIC AND CONGENITAL HEART SURGERY, v.10, n.2, p.164-170, 2019
dc.description.abstractIntroduction: Single ventricle physiology management is challenging, especially in low-income countries Objective: To report the palliation outcomes of single ventricle patients in a developing African country. Methods: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock-Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). Results: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P = .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P = .002) impacted survival. Conclusion: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.eng
dc.relation.ispartofWorld Journal for Pediatric and Congenital Heart Surgery
dc.subjectsingle ventricleeng
dc.subjectFontan procedureeng
dc.subjectGlenn procedureeng
dc.subjectBlalock-Taussig shunteng
dc.subjectpulmonary artery bandingeng
dc.subject.othercongenital heart-diseaseeng
dc.subject.otherblalock-taussig shunteng
dc.subject.otherbidirectional glenneng
dc.subject.otherfontan operationeng
dc.titleSingle Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?eng
dc.rights.holderCopyright SAGE PUBLICATIONS INCeng
dc.subject.wosCardiac & Cardiovascular Systemseng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, Humberto:Hosp Mil Principal, Inst Super, Cardiol Dept, Luanda, Angola, Gade:Clin Girassol, Cardiothorac Ctr, Luanda, Angola, Albino:Clin Girassol, Cardiothorac Ctr, Luanda, Angola; Portuguese Red Cross Hosp, Pediat Cardiol Dept, Cardiac Surg Dept, Lisbon, Portugal, Maria A. S.:Clin Girassol, Cardiothorac Ctr, Luanda, Angola; Portuguese Red Cross Hosp, Pediat Cardiol Dept, Cardiac Surg Dept, Lisbon, Portugal, Gilberto:Clin Girassol, Cardiothorac Ctr, Luanda, Angola, Manuel Pedro:Clin Girassol, Cardiothorac Ctr, Luanda, Angola; Portuguese Red Cross Hosp, Pediat Cardiol Dept, Cardiac Surg Dept, Lisbon, Portugal, Telmo:Clin Girassol, Cardiothorac Ctr, Luanda, Angola, Antonio P. F.:Clin Girassol, Cardiothorac Ctr, Luanda, Angola
hcfmusp.publisher.cityTHOUSAND OAKSeng
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Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/11
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação

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