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J Thorac Cardiovasc Surg 2007;134:1436-1437
© 2007 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Discussion

The first 20% of the full text of this article appears below.

Dr Edward L. Bove (Ann Arbor, Mich). I would like to thank Dr Hickey and his coauthors from the CHSS for an excellent study with a new, at least to me, statistical evaluation tool. In this presentation, the authors have asked the age-old question: "Is a high-risk BVR better than a low-risk UVR approach?" Despite the substantial decline in early mortality for univentricular approaches, most centers still desire to push borderline patients to a BVR, believing that it is safer and affords better long-term outcome. The authors have documented that the first assumption is not always correct, although the second still remains uncertain. Further complicating this decision process is the realization that, at least for the types of patients in this particular analysis, namely, those with critical LVOT obstruction, the single-ventricle approach perhaps offers the best outcomes among many variants of hypoplastic left heart syndrome.

The authors performed an exhaustive analysis of multiple risk factors for death for both UVR and BVR and then formed a UVR-SA tool that allowed them to . . . [Full Text of this Article]


Related Article

Critical left ventricular outflow tract obstruction: The disproportionate impact of biventricular repair in borderline cases
Edward J. Hickey, Christopher A. Caldarone, Eugene H. Blackstone, Gary K. Lofland, Thomas Yeh, Jr, Christian Pizarro, Christo I. Tchervenkov, Frank Pigula, David M. Overman, Marshall L. Jacobs, Brian W. McCrindle Congenital Heart Surgeons’ Society
J. Thorac. Cardiovasc. Surg. 2007 134: 1429-1437. [Abstract] [Full Text] [PDF]





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