Blalock-Taussig Shunt Size: Should it be Based on Body Weight or Target Branch Pulmonary Artery Size?

Basit Öğe Kaydı
dc.contributor.authorSisli, Emrah
dc.contributor.authorTuncer, Osman Nuri
dc.contributor.authorSenkaya, Suat
dc.contributor.authorDogan, Eser
dc.contributor.authorSahin, Hatice
dc.contributor.authorAyik, Mehmet Fatih
dc.contributor.authorAtay, Yueksel
dc.date.accessioned2019-10-27T09:59:13Z
dc.date.available2019-10-27T09:59:13Z
dc.date.issued2019
dc.departmentEge Üniversitesien_US
dc.description.abstractThe study aimed to revisit the in-hospital predictors of shunt thrombosis (ST) in the foreground of the pulmonary artery size in patients who received modified Blalock-Taussig shunt (mBTS) as the first-stage palliation. Data from 80 patients who received mBTS as their initial palliative procedure between February 2012 and January 2017 was retrospectively collected. The median age and weight of the patients at the time of their mBTS procedure was 4days (IQR 2-22days) and 3.2kg (IQR 2.8-3.7kg), respectively. Of the 80 patients in the study, 11 (13.8%) developed ST. The diameter and corresponding z scores of the pulmonary arteries were significantly lower in patients with ST. The median shunt size/shunted pulmonary artery size (S/PA) ratio was considerably higher in patients with ST. In logistic regression analysis, pulmonary artery hypoplasia (PAH) [odds ratio (OR)=13.7 (0.06-0.21), p<0.001], S/PA ratio0.9 [OR=8.1 (0.03-0.53), p=0.03], prematurity [OR=9.5 (0.05-0.33), p=0.003], and shunt size/weight (S/W) ratio1.3 [OR=6.4 (0.04-0.67), p=0.012] were found to have a significant impact on ST. The best combination of sensitivity and specificity of the S/W (0.73 and 0.75) and the S/PA ratio (0.73 and 0.80) were achieved at the cut-off value of 1.3 and 0.9, respectively. The Youden index of S/PA was 0.52. While the area under the curve (AUC) of the S/W ratio was 0.686 +/- 0.12 (p=0.049), the AUC of the S/PA ratio was 0.791 +/- 0.08 (p=0.002). In conclusion, instead of weight, considering the size of the target pulmonary artery and thereby, the S/PA ratio would be more instructive in determining shunt size. There were a high number of patients in our study who showed PAH having received a shunt size based on their body weight. By contrast, our results showed that the S/PA ratio of 0.9 would be a good predictor of in-hospital ST.en_US
dc.identifier.doi10.1007/s00246-018-1958-9en_US
dc.identifier.endpage44en_US
dc.identifier.issn0172-0643
dc.identifier.issn1432-1971
dc.identifier.issue1en_US
dc.identifier.pmid30121861en_US
dc.identifier.startpage38en_US
dc.identifier.urihttps://doi.org/10.1007/s00246-018-1958-9
dc.identifier.urihttps://hdl.handle.net/11454/29584
dc.identifier.volume40en_US
dc.identifier.wosWOS:000456807300005en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofPediatric Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBlalock-Taussig shunten_US
dc.subjectmodifieden_US
dc.subjectIn-hospital mortalityen_US
dc.subjectPulmonary arteryen_US
dc.subjectHypoplasiaen_US
dc.titleBlalock-Taussig Shunt Size: Should it be Based on Body Weight or Target Branch Pulmonary Artery Size?en_US
dc.typeArticleen_US

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu