Age Criteria As Operative Mortality Predictor After Modified Blalock-Taussig Shunt

Abstract

Background: Modified Blalock-Taussig shunt (MBTS) is considered as a simple procedure but has a considerable operative mortality rate. Patient’s characteristics who underwent MBTS in Indonesia is quite different than other country. There was no predictor of operative mortality has been identified in Indonesian.

Objectives: To compare mortality rate based on age criteria and to identify mortality and morbidity predictors after MBTS procedure.

Methods: A retrospectively cohort study was conducted on 400 patients who underwent MBTS at National cardiovascular center Harapan Kita (NCCHK) between January 2013 and december 2017.

Results: There were 32,1% death at age ≤ 28 days, 19,9% at age 29-365 days, 3,6% at age 366-1825 days and 8% at age > 1825 days. Body weight < 3 kg, haematocrite level > 45% before procedure and activated partial thromboplastine time level (aPTT) < 60 seconds were operative mortality  predictors. Postoperative morbidity rate was 32,9%. Packed red cell  transfusion (PRC) more than 6 ml/kg, mechanical ventilator use before procedure, prostaglandin E1 use before procedure, aPTT level less than 60 seconds after procedure were identified as postoperative morbidity predictors.

Conclusion: Operative mortality rate significantly different among age criteria but it was not proven as an operative mortality predictors. Body weight < 3 kg increase mortality rate and haematocrite level higher than 45% and aPTT level less than 60 seconds decrease mortality rate. Postoperative morbidity predictors were PRC transfusion more than 6ml/kg, mechanical ventilator use before procedure, prostaglandine E1 use and aPTT level less than 60 seconds.

Downloads

Download data is not yet available.

References

1. Alsoufi B, Gillespie S, Mori M, Clabby M, Kanter K, Kogon B. Factors affecting death and progression towards next stage following modified Blalock-Taussig shunt in neonates. European Journal Cardio-thoracic Surgery. 2016;50(1):169–77.
2. Dave HH. Modified Blalock-Taussig shunt: Simple but unpredictable. European Journal Cardio-thoracic Surgery. 2016;50(1):178–9.
3. Bove T, Vandekerckhove K, Panzer J, de Groote K, de Wolf D, François K. Disease-Specific Outcome Analysis of Palliation With the Modified Blalock-Taussig Shunt. World Journal Pediatric Congenital Heart Surgery. 2015;6(1):67–74.
4. Hoffman JIE. The global burden of congenital heart disease : review article. Cardiovascular Journal African. 2013;24(4):141–5.
5. Singh S, Chauhan S, Choudhury M, Malik V, Hote M, Devagourou V, et al. Modified Blalock Taussig shunt: Comparison between neonates, infants and older children. Annals Cardiac Anaesthesia. 2014;17(3):191-8.
6. Petrucci O, O’Brien SM, Jacobs ML, Jacobs JP, Manning PB, Eghtesady P. Risk factors for mortality and morbidity after the neonatal Blalock-Taussig shunt procedure. Annals Thoracic Surgery. 2011;92(2):642–52.
7. Hobbes B, d’Udekem Y, Zannino D, Konstantinov IE, Brizard C, Brink J. Determinants of Adverse Outcomes After Systemic-To-Pulmonary Shunts in Biventricular Circulation. Annals Thoracic Surgery. 2017;104(4):1365–70.
8. Park MK. Pathophysiology of Cyanotic Congenital heart disease. In: Park MK, Park's Pediatric Cardiology For Practitioners 6th edition. Philadelphia: Elsevier Saunder;2014
9. Kiran U, Aggarwal S, Choudhary A, Uma B, Kapoor PM. The Blalock and Taussig Shunt Revisited. Annals Cardiac Anaesthesia. 2017;20(4):395–8.
10. Küçük M, Özdemir R, Karaçelik M, Doksöz Ö, Karadeniz C, Yozgat Y, et al. Risk factors for thrombosis, overshunting and death in infants after modified blalock-Taussig shunt. Acta Cardiology Sin. 2016;32(3):337–42.
11. Dorneles CDC, Bodanese LC, Guaragna JCVDC, Macagnan FE, Coelho JC, Borges AP, et al. The impact of blood transfusion on morbidity and mortality after cardiac surgery. Rev Bras Cir Cardiovascular. 2011;26(2):222–9.
Published
2019-09-11
How to Cite
Age Criteria As Operative Mortality Predictor After Modified Blalock-Taussig Shunt. (2019). Indonesian Journal of Cardiology, 40(1). https://doi.org/10.30701/ijc.v40i1.763