Conexão cavopulmonar parcial como primeiro estágio no tratamento do coração univentricular em um centro na Amazônia: resultados imediatos

Abstract

Objective: To evaluate the efficacy of the bidirectional cavopulmonary connection as primary palliation in the treatment of the univentricular heart in patients older than three months. Methods: We retrospectively evaluated the medical records of patients with congenital heart defects with univentricular morphophysiology undergoing cavopulmonary connection as first stage. The following parameters were evaluated: age, gender, anatomical diagnosis, associated heart defects, time of extracorporeal circulation, intubation time, length of hospital stay and postoperative complications, variation of peripheral oxygen saturation and pre and postoperative pulmonary artery systolic pressure was evaluated. The main anatomical characteristics of the heart defects were tricuspid atresia and single ventricle left type. Results: Eleven cases of children submitted to a partial cavopulmonary connection as primary palliation were identified. The mean age was 10.54 months, with a slight prevalence of females (54.54%). There was an increase in oxygen saturation ranging from a mean of 74.46% to 88.27% (p <0.01), with pulmonary artery systolic pressure adjusting from 20.80mmHg to 17.80mmHg (p <0.05). There were two cases of phrenic paresis and one case of chylothorax which were corrected surgically. There were no deaths in the sample. Conclusion: Initial approach in univentricular repair is safe and showed reasonable early outcomes when performed after 3 months of age.