The impact of a dedicated single-ventricle home-monitoring program on interstage somatic growth, interstage attrition, and 1-year survival Christopher.

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Presentation transcript:

The impact of a dedicated single-ventricle home-monitoring program on interstage somatic growth, interstage attrition, and 1-year survival Christopher J. Petit, MD, Charles D. Fraser, MD, Raphael Mattamal, BS, Timothy C. Slesnick, MD, Constance E. Cephus, MSN, Elena C. Ocampo, MD The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 6, Pages 1358-1366 (December 2011) DOI: 10.1016/j.jtcvs.2011.04.043 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Interstage weight gain in the SVP group outpaced the growth rate in the pre-SVP group. The SVP group was promoted to S2P at an earlier age and yet had achieved a similar weight at an earlier time compared with the pre-SVP group. SVP, Single Ventricle Program; S1P, stage 1 palliation; S2P, stage 2 palliation. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1358-1366DOI: (10.1016/j.jtcvs.2011.04.043) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Kaplan–Meier analysis of survival between S1P and S2P. Both in-hospital death after S1P and ID are included in the mortality for these analyses. A, Survival between the SVP and the pre-SVP cohorts is compared. The SVP cohort has a lower rate of in-hospital and ID. B, Among the entire cohort, patients with HLHS are at higher risk for pre-S2P mortality when they are compared with the remainder of the cohort. SVP, Single Ventricle Program; S1P, stage 1 palliation; S2P, stage 2 palliation; HLHS, hypoplastic left heart syndrome. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1358-1366DOI: (10.1016/j.jtcvs.2011.04.043) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Kaplan–Meier analysis of 1-year transplant-free survival. A, Among the entire single-ventricle cohort (both SVP and pre-SVP), the 1-year transplant-free survival is 76.3%. The majority of events occur before 0.3 years. B, There is improvement in 1-year transplant-free survival in the SVP cohort. SVP, Single Ventricle Program. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1358-1366DOI: (10.1016/j.jtcvs.2011.04.043) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Timeline of mortality events (death or heart transplantation) in pre-SVP (dark grey) and SVP (light grey) groups. The timeline demonstrates that the majority of events occurred early (<0.4 years). SVP, Single Ventricle Program. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1358-1366DOI: (10.1016/j.jtcvs.2011.04.043) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Kaplan–Meier analysis of 1-year transplant-free survival in the subgroup of patients with a single ventricle who underwent Norwood-type palliation at S1P. A, The SVP cohort experienced improved 1-year transplant-free survival. B, There is no statistically significant improvement in 1-year transplant-free survival with the modified Norwood with RVPA conduit. C, BT shunt group appears to have improved survival at 1 year, but this difference in survival fails to reach statistical significance. SVP, Single Ventricle Program; BT, Blalock–Taussig. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1358-1366DOI: (10.1016/j.jtcvs.2011.04.043) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions